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Pain pump coding

  1. #1
    Default Pain pump coding
    Medical Coding Books
    How would you code this scenario?

    The pump is located in the lower quadrant and is prepped in the
    usual fashion with the side access port located at approximately
    12 o'clock. Utilizing the template guide, a 22-gauge Huber needle was
    introduced through the diaphragm and placement was confirmed with
    aspiration. The pump contents were emptied and subsequently, 20m1 of
    preservative-free Morphine 30mg/ml + Marcaine 7.5mg/ml solution was
    introduced. Position was once again confirmed with aspiration. The pump
    was reprogrammed to reflect the increase in volume and a 16,489 mg/mcg
    per day rate of infusion.

    Service is performed by a NP, no physician has signed off.

    ? 95990, 62368, J2275 X ___, and ?? for the 7.5mg/ml marcaine.

    Please bear with me, I'm very new to this type of coding. I've only coded the E&M services in the past and the pump refills have just started coming through with my other services.



  2. #2
    Denver Colorado
    If the pump refill medications were compounded by a special compounding pharmacist, as is common for pump refills, rather than using the commercially available drugs, some payers require providers to report compounded drugs with J3490 and potentially send in the invoice for the med.

    The key questions are:
    Was the refill medication compounded?
    If yes, how does the payer require compounded meds to be billed?

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