Pump Analyze & Reprogram 62368

g.fairchild

Networker
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Hi All,

Just want to throw this out there....if the manufacturer of the Intrathecal Pump comes into the office and does the analyze & reprogram (62368), WITHOUT any interaction between one of our Physicians (or NP's) and the patient, can we bill the 62368??

If so, does the Physician have to dictate a note, or will the pump printout suffice as far as documentation goes?

One of my Doc's feels we can bill this, and I tended to disagree because it was not one of our employees.

Any thoughts are GREATLY APPRECIATED!!

Thanks Much,
A Pain
 

dwaldman

True Blue
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"From a CPT coding perspective, based on the information available in your inquiry, and in answer to your question, CPT is a set of codes, descriptions, and guidelines intended to describe procedures and services performed by physicians and other health care providers, therefore, it would not be appropriate to report this code if performed by a manufacturer's representative."
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Above is a part of response I received from the AMA CPT Network in regards to 95972 from November 2010. I know your question is about 62368 but it is the same concept From the response i have received, I have come to this conclusion: It has to be perform by the physician And if the service is soley provided by the Manufacturer's representative regardless of whether the physician is present or not it is NOT a reportable service. At least that is my interpretation of their response. I would explain to the physician that "assuming" you can bill something a certain way can lead to improper payment or misinterpretation of the intent of CPT. I would suggest to him that you poise this question to the AMA via The CPT Network. It would cost 80 dollars. I believe you will get a similiar response as what I have received.
 

g.fairchild

Networker
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Thank you so much for the assistance...I greatly appreciate it, and tend to agree with what is written here...

The manufacturer's representative is NOT one of our employees.....and as you say, CPT was for purpose of Physician coding and billing.
 
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