How To Bill Reservoir/Pump Installation | CPT Codes & Billing Guide
Reservoir/Pump Implantation installation is described by the CPT manual with CPT 62360, CPT 62361, CPT 62362, CPT 62365, CPT 62367, CPT 62368, CPT 62369 & CPT 62370. Below are the descriptions and billing guidelines of the CPT codes for reservoir/pump installation.
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1. General Billing Guidelines
Do not report CPT 62367, CPT 62368, CPT 62369 or CPT 62370 in conjunction with CPT 95990 or CPT 95991.
Report CPT 95990 or CPT 95991 for maintenance and refilling a implantable infusion pump or reservoir for brain or spinal drug delivery without reprogramming.
2. CPT62360
CPT code62360 is described by the CPT manual as: “Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir.”
2.1 Procedure
The goal of the62360 CPT code procedure is to replace a reservoir under a patient’s skin for epidural or intrathecal infusion of medications.
In this procedure, the provider places a drug reservoir subcutaneously for the infusion of medications through a tunneled catheter into the intrathecal or epidural space.
When the patient is appropriately prepped and anesthetized, the provider makes an incision at the placement site, typically in the abdomen.
If the procedure is an initial implant, she creates a pocket in the deep subcutaneous tissue and places a reservoir into the pocket.
Using a tunneling device, she makes a subcutaneous tunnel between the reservoir and the spinal incision, attaches a spinal catheter to the tunneling device with a suture, and pulls the spinal catheter through the subcutaneous tunnel to the reservoir.
Next, she verifies the catheter patency, meaning that it is open and unobstructed, and she connects the catheter to the reservoir and secures it with sutures.
If she replaces an existing reservoir, she reopens the scar from the placement procedure.
She then removes the previously implanted reservoir, replaces it with a new one, and attaches the existing implanted catheter, suturing it to the reservoir to secure the connection.
Whenthe CPT code 62360 procedure is complete, she irrigates the wound, then closes and dresses the incision.
3. CPT 62361
CPT code 62361 is described by the CPT manual as: “Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump.”
3.1 Procedure
The 62361 CPT code procedure aims to replace or implant a nonprogrammable pump under the patient’s skin for epidural or intrathecal medication.
In this procedure, the provider places a nonprogrammable pump subcutaneously for the continuous infusion of medications through a tunneled catheter into the intrathecal or epidural space.
When the patient is appropriately prepped and anesthetized, the provider makes an incision at the placement site, typically in the abdomen. If the procedure is an initial implant, she creates a pocket in the deep subcutaneous tissue and places the drug-filled nonprogrammable pump into the pocket.
Using a tunneling device, she makes a subcutaneous tunnel between the pump and the spinal incision, attaches a spinal catheter to the tunneling device with a suture, and pulls the spinal catheter through the subcutaneous tunnel to the subcutaneous pocket.
Next, she verifies the catheter patency, meaning that it is open and unobstructed, and she connects the catheter to the pump and secures it with sutures.
If she replaces an existing pump, she reopens the scar from the placement procedure.
She then removes the previously implanted pump, replaces it with a new one, and attaches the existing implanted catheter, suturing it to the pump to secure the connection.
When the CPT code 62361 procedure is complete, she irrigates the wound, then closes and dresses the incision.
4. CPT 62362
CPT code 62362 is described by the CPT manual as: “Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming.”
4.1 Procedure
The 62362 CPT code procedure aims to replace or implant a programmable pump under a patient’s skin for epidural or intrathecal infusion of medications.
In this procedure, the provider places a programmable pump subcutaneously for the continuous infusion of medications through a tunneled catheter into the intrathecal or epidural space.
The provider begins preparing the pump for implantation when the patient is appropriately prepped and anesthetized.
First, she warms the device and then removes the sterile water, replacing it with the prescribed medication.
Then she makes an incision at the placement site, typically in the patient’s abdomen. If the procedure is an initial implant, she creates a pocket in the deep subcutaneous tissue and places the drug-filled programmable pump into the pocket.
Using a tunneling device, she makes a subcutaneous tunnel between the pump and the spinal incision, attaches a spinal catheter to the tunneling device with a suture, and pulls the spinal catheter through the subcutaneous tunnel to the pump.
Next, she verifies the catheter patency, meaning that it is open and unobstructed, and she connects the catheter to the pump and secures it with sutures.
If she replaces an existing pump, she reopens the scar from the placement procedure.
She then removes the previously implanted pump, replaces it with a new one, and attaches the existing implanted catheter, suturing it to the pump to secure the connection.
When the CPT code 62362 procedure is complete, she irrigates the wound, then closes and dresses the incision.
5. CPT 62365
CPT code 62365 is described by the CPT manual as: “Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion.”
5.1 Procedure
The goal of the 62365 CPT code procedure is to remove a pump or reservoir implanted under the patient’s skin for epidural or intrathecal medication infusion.
The provider identifies the surgical site to access the reservoir or pump when the patient is appropriately prepped and anesthetized.
She then reopens the incision from the prior procedure over the implanted device and releases the sutures that anchor the device in place.
She then exposes the connection to the implanted device by cutting down the surrounding scar and soft tissue.
She disconnects the catheter from the reservoir or pump and removes the device.
Next, she ties and divides the catheter or removes it, withdrawing it from its location in the spine.
If she removes the catheter, she closes the catheter track to reduce cerebrospinal fluid leakage or the possibility of infection.
When the CPT code 62365 procedure is complete, she irrigates the pocket, and she may insert external drainage, then closes and dresses the wound.
6. CPT 62367
CPT code 62367 is described by the CPT manual as: “Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming or refill.”
6.1 Procedure
The goal of the 62367 CPT code procedure is to analyze the performance of an implantable pump without reprogramming or refilling the pump.
The provider places electrodes on the skin at the site of the implanted pump to monitor its performance on a computer.
In this procedure, the electronic analysis shows a satisfactory or unsatisfactory infusion rate, residual volume, and alarm status.
The provider does not reprogram the pump during this service.
6.2 Billing Guidelines
The provider for CPT 62367 can include the physician, physician assistant, nurse, or physical therapist.
7. CPT 62368
CPT code 62368 is described by the CPT manual as: “Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming.”
7.1 Procedure
The goal of the 62368 CPT code procedure is to analyze the performance of an implantable pump with reprogramming but without refilling.
The provider places electrodes on the skin at the site of the implanted pump to monitor its performance on a computer.
In the 62368 procedure, the electronic analysis shows a satisfactory or unsatisfactory infusion rate, residual volume, and alarm status.
The provider does not reprogram the pump during this service. The provider reprograms the infusion rate to increase the infusion rate to treat a patient with increased pain.
7.2 Billing Guidelines
The provider for CPT 62368 can include the physician, physician assistant, nurse, or physical therapist.
Report CPT 95990 or CPT 95991 for refilling and maintaining an implantable infusion pump for spinal or brain drug therapy.
8. CPT 62369
CPT code 62369 is described by the CPT manual as: “Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill.”
8.1 Procedure
The goal of the 62369 CPT code procedure is to analyze the performance of an implantable pump with reprogramming and refilling.
To monitor the performance of a pump on a computer, the provider places electrodes at the site of the implanted pump. Then, the provider reprograms the pump and refills the pump with a drug.
8.2 Billing Guidelines
The provider for CPT 62369 can include the physician, physician assistant, nurse, or physical therapist.
9. CPT 62370
CPT code 62370 is described by the CPT manual as: “Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill (requiring skill of a physician or other qualified health care professional).”
9.1 Procedure
The goal of the 62370 CPT code procedure is to analyze the performance of an implantable pump with reprogramming and refilling which requires the skill of a physician or other qualified health care professional.
To monitor the performance of a pump on a computer, the provider places electrodes at the site of the implanted pump. Then, the qualified provider or physician reprograms the pump and refills the pump with a drug.
