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Wiki Post-op pain pumps

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roeschkn

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I am working with an orthopedic practice who would like to use post-op pain pumps for their shoulder and knee surgeries. Do you find most payers are considering this a bundled service? If not, what code is being used for the pump?
 
in our office we use the unlisted codes 23929 (shoulder) and 27599 (knee). Yes, there are alot that see it as inclusive but some do pay.
 
In the January 2007 Orthropedic Coder's Pink Sheet, there is reference on page 5 that states that it may not be separately billable, that Medicare considers this to be part of the global surgical package (See the claims processing manual, 100-4, Chap 12, section 40). Reference is also made that the AMA (CPT) agrees with this statement.

However, at the end of the article it does state:
Some private payor may allow you to negotiate payment for these implanted post-op pain pumps into your payer contracts. If so, the AAOS recommends you report 64999 for this.

Hope this helps
Mary
 
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