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Morphine Pain Pump Trial

Messages
5
Location
Orwigsburg, PA
Best answers
0
Please help.

Preop Diagnosis: 1. Advanced carcinoma lung with persistent pain
2. Narcotic dependent for pain control

DESCRIPTION OF PROCEDURE:
All the risks, benefits, complication, alternative were explained to the patient. The case was also discussed in detail with the family. The patient signed for the informed consent. All the risks, benefits, complications including infection, hand phlebitis, morphine overdose were explained to the patient. The family and the patient signed for the informed consent. He was taken to the procedure room and was placed prone on the fluoroscopic table. Lumbosacral area was cleaned and prepped in usual sterile fashion. Sterile drapes were placed. Under fluoroscopic control interspinous space between L4-L5 was identified. Entry site of the needle was marked with a skin marker. 1 mL of 1% lidocaine was given as local anesthesia in subcutaneous tissue. Using 22-gauge spinal needle and using gun barrel technique, needle was advanced till it lie in the subarachnoid space. Clear CSF was seen coming out of the needle. 0.5 mg preservative morphine, also called Duramorph, was injected into the intrathecal space. The needle was removed. There was no complication. Band-Aid was applied and the patient was turned supine. He will be kept overnight in the hospital to see the success of the trial and to prevent any respiratory depression because the patient is on high dose narcotics.

I thought 62311 would possibly be the code to use but the Dx do not meet Medical Necessity.
 

mhstrauss

True Blue
Messages
1,241
Location
Baton Rouge
Best answers
0
Please help.

Preop Diagnosis: 1. Advanced carcinoma lung with persistent pain
2. Narcotic dependent for pain control

DESCRIPTION OF PROCEDURE:
All the risks, benefits, complication, alternative were explained to the patient. The case was also discussed in detail with the family. The patient signed for the informed consent. All the risks, benefits, complications including infection, hand phlebitis, morphine overdose were explained to the patient. The family and the patient signed for the informed consent. He was taken to the procedure room and was placed prone on the fluoroscopic table. Lumbosacral area was cleaned and prepped in usual sterile fashion. Sterile drapes were placed. Under fluoroscopic control interspinous space between L4-L5 was identified. Entry site of the needle was marked with a skin marker. 1 mL of 1% lidocaine was given as local anesthesia in subcutaneous tissue. Using 22-gauge spinal needle and using gun barrel technique, needle was advanced till it lie in the subarachnoid space. Clear CSF was seen coming out of the needle. 0.5 mg preservative morphine, also called Duramorph, was injected into the intrathecal space. The needle was removed. There was no complication. Band-Aid was applied and the patient was turned supine. He will be kept overnight in the hospital to see the success of the trial and to prevent any respiratory depression because the patient is on high dose narcotics.

I thought 62311 would possibly be the code to use but the Dx do not meet Medical Necessity.
62311 is the correct CPT, but yes, not all payers have pain pump dx on their coverage policies.
What about G89.3--chronic pain due to neoplasm? Has the doctor documented chronic pain?
 

marvelh

Expert
Messages
304
Location
Denver Colorado
Best answers
0
The G89.3 code does not require a provider's documentation of acute or chronic. The ICD-10 guidelines state "Code G89.3 is assigned to pain documented as being related, associated or due to cancer, primary or secondary malignancy, or tumor. This code is assigned regardless of whether the pain is acute or chronic. This code may be assigned as the principal or first-listed code when the stated reason for the admission/encounter is documented as pain control/pain management. The underlying neoplasm should be reported as an additional diagnosis."
 
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