Wiki how to calculate units on pain pump medication

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Bakerkar

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Please could anyone advise how to calculate the number of units I would bill for the following:
Utilizing a Medtronic refill kit the intrthecal pump reservoir contents were removed revealing a residual of 3.8cc with expected residual volume of 2.7cc. Pump was refilled with 19cc of Baclofen 5000 mch/ml. The pump was reprogrammed to deliver Baclofen 675.2 mcg/24 hours. HCPCS J0475
 
Bakerkar said:
Please could anyone advise how to calculate the number of units I would bill for the following:
Utilizing a Medtronic refill kit the intrthecal pump reservoir contents were removed revealing a residual of 3.8cc with expected residual volume of 2.7cc. Pump was refilled with 19cc of Baclofen 5000 mch/ml. The pump was reprogrammed to deliver Baclofen 675.2 mcg/24 hours. HCPCS J0475
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The Medtronics website has great info; here is the link:

http://www.medtronic.com/for-healthcare-professionals/reimbursement/index.htm

just go down to the "neuro" section and select "ITB" therapy. My clinic has it blocked, so I can't access it right now, but I know I've used it before.

Also, double check the dosage you have listed above...5000 mcg sounds pretty high...maybe should be 500 ? Just wanted to point that out. If it is 500, you would bill 1 unit of J0475. I have a small "cheatsheet" spreadsheet of the most common baclofen kits we use; send me your email address if you'd like me to send it to you.

THT!
 
I agree to double check the Baclofen dosage. The commercially available dosage for intrathecal baclofen include:
Gablofen: 50 mcg/ml, 500 mcg/ml, 1000 mcg/ml and 2000 mcg/ml​

Lioresal: 50 mcg/ml, 500 mcg/ml and 2000 mcg/ml​

If the dosage was 500 mcg/ml, then you multiply the dosage times the volume injected (500 x 19) or 9,500 mcg total

The J0475 code is based on 10 mg which equals 10,000 mcg (1000 mcg = 1 mg) so you would bill 1 unit of the J0475.

If the dosage is 5000 mcg / ml, then check to see if the refill was compounded to that strength specially for that patient. If that is the case, you will need to check to see how the payer wants compounded meds to be reported. Many require the J3490 code.
 
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