Question PAIN MGMT BILLING QUESTION

cherylbr

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I need help on this one. I was thinking 61070, 62368, 77002. Not sure about 61070 as is this code for brain because this was in the lumbar area?

Can someone please help with how to code this op note:

PAIN PUMP] CATHETER STUDY

Post-Op Diagnosis Codes: Chronic bilateral low back pain, unspecified whether sciatica present

Procedure(s): CATHETER DYE STUDY

TECHNIQUE:
Patient was admitted to the pain unit- all consents today reviewed and signed. Patient transferred to the
operating suite where he was placed in supine position operating table. Routine prep drape was performed.
With the aid of fluoroscopy the catheter port on the patient's intrathecal pain pump was identified. Local
anesthesia was infiltrated. A short bevel 22 gauge needle was inserted through the skin subcu tissue to
access the pump catheter port. Aspiration was positive for clear fluid. The fluid was tested for glucose and
was positive indicating CSF. Catheter placement was verified as correct. Patient's intrathecal pain pump was
then programmed for a bridge bolus and an increase of his 24 hr dosage by 10%. He was instructed follow up
in the office for postprocedure evaluation and continue on his current medications. His refill date was provided
to him. He will be referred for a neurosurgical consultation.
 

SharonCollachi

True Blue
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Clovis, CA
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61070 Puncture of shunt tubing or reservoir for aspiration or injection procedure (nervous system - skull/meninges/brain)
62368 Electronic Analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming.
77002 Fluoroscopic guidance for needle placement.

I agree that 61070 is not the right code. And 62368 alone does not describe the full extent of what was done. If he had done a dye study instead of testing the fluid for glucose, it would have been easy (75809). I think you're going to have to use an unlisted code as I couldn't find a specific CPT code. By the way, was he not responding to the pump? Were they suspicious that the catheter had migrated (and couldn't see it on imaging)? Just curious.
 

cherylbr

Networker
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61070 Puncture of shunt tubing or reservoir for aspiration or injection procedure (nervous system - skull/meninges/brain)
62368 Electronic Analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming.
77002 Fluoroscopic guidance for needle placement.

I agree that 61070 is not the right code. And 62368 alone does not describe the full extent of what was done. If he had done a dye study instead of testing the fluid for glucose, it would have been easy (75809). I think you're going to have to use an unlisted code as I couldn't find a specific CPT code. By the way, was he not responding to the pump? Were they suspicious that the catheter had migrated (and couldn't see it on imaging)? Just curious.
SHARON,
Thank you very much for your help on this!

Very much appreciated!

Have a great day!

Cheryl
 
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