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Wiki Pain Pump

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kmcafee

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How do you all code for pain pump insertion or do you? We have been using 49999 and getting constant denials. I have been told never to for the pain pumps and to code for them. I need help!!!!:confused:
 
re: pain pump

i use 49999 with a 59 modifer. i only bill these to medicare and commercial insurance. i always send op notes because it is an unlisted procedure code. hope this helps!
 
Use code 62362: Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming

Hope this helps. 62363 is the removal of it
 
My take on it is that On-Q is local anesthesia which is bundled with the procedure.

Here's what I found on the internet:

https://www.noridianmedicare.com/cg...S&tmpl=part_b_viewnews&style=part_ab_viewnews

Per Noridian:

Placement and management of these pumps by the surgeon is included in the global component of the surgical procedure code and is not separately payable per the CMS Internet Only Manual (IOM), Publication 100-04.

In general, I'm very cautious billing how company reps tell me to.
 
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