Wiki Intrathecal infusion pumps

[alysonrs]

Can anyone offer any advise on billing for an intrathecal infusion pump??
So far I have
62362 for the insertion
96425 for the initiation
95990 or 95991 for refilling and maintenance
drug infused
62367 electronic anaylsis
62365 removal

Also,
would you be able to bill for an office visit on the same day as the initiation or refilling of pump??

 

[Walker22]

96425 is not applicable for intrathecal infusion pumps. That code is for intra-arterial push, not intrthecal push.

You can bill a separate office visit if you have the documentation to support it. It would have to be a separately identifiable OV that is beyond and above what is normally required for the pump refill. See the mod-25 guidelines for more info.

 

[cmcgarry]

For your codes after the initial insertion, there is also 62368 for analysis with reprogramming (62367 is without). Also, for refills, remember that 95991 is the one to use if the physician does the refill. Don't forget to also bill out the drugs used to fill the pump. If you will be using compounded medications be sure to check with your carriers on how they want you to bill those out. It can be very tricky. Good luck,

Cindy Mc
CPC-P