IT Pump in abdomen 'flipped' - manual external manipulation under fluoro to correct


Metairie, LA
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What can I bill for the repositioning of the pump?? This was performed in the office.

I'm fairly new to pain management billing but this seems like a rare situation! Any more experienced billers out there able to shed some light on this?

Pt is a 72 year old female referred by Dr. X for 2nd opinion and help with difficult case. Pt has chronic back and shoulder pain and is s/p C3-T8 fusion. She had an IT pump placed in her abdomen by Dr. R. She has lost significant weight since then. The pump is initially unreadable. Pt was taken to the procedure room and the pump was identified under fluoroscopy to be a Flowonix pump that had flipped. Pt was taken back to the exam room and the pump was flipped back over using manual external manipulation. The pump was then able to be read. Pump is due for refill by Jan 4. Will schedule refill. Pt also with pain in the bilateral SI joints that is overriding her other pain. She also has cervical facet pain from c3-C6 bilaterally.



True Blue
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Revision of Pump12 64999 Unlisted procedures, nervous system

12. Pump revision includes procedures such as reshaping the pocket, relocating the pocket, or opening the pocket to correct a flipped pump or reconnect the catheter, all while
re-inserting the existing pump without replacing it with a new pump. There is no CPT code specifically defined for pump revision so an unlisted code is used. For Medicare,
the unlisted code is contractor-priced. Contractors establish the RVUs and the payment amount, usually on an individual basis after review of the procedure report.