Anesthesia Coding Alert

Question: Our pain specialist used fluoroscopy to inject medication into a patient's infusion pump. She used fluoroscopy with contrast to rule out any leakage or kinking of the catheter, and then completed a lumbosacral myelogram. How should we code this encounter?


Montana Subscriber

Answer: Submit 75809 (Shuntogram for investigation of previously placed indwelling nonvascular shunt [e.g., LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump], radiological supervision and interpretation) for the fluoroscopic evaluation, and then move to the infusion itself.
 
Report 95991 (Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal [intrathecal, epidural] or brain [intraventricular]; administered by physician) for the pump injection. Add 61070 (Puncture of shunt tubing or reservoir for aspiration or injection procedure) for the catheter dye study.

Your final component is myelography. If your physician performed the entire procedure, submit 62284 (Injection procedure for myelography and/or computed tomography, spinal [other than C1-C2 and posterior fossa]) with modifier 59 (Distinct procedural service). If, however, your physician performed part of the procedure, append modifier 52 (Reduced services) instead.