Anesthesia Coding Alert

Question: The pain management specialist completed a patent test and aspirated all the medication out of the patient’s pain pump. She then refilled the pump with the same medication that was aspirated. Since she refilled with the same medication that was withdrawn from the pump, does it still qualify as a refill?

North Dakota Subscriber

Answer: Three codes are applicable in this situation:

• 61070 (Puncture of shunt tubing or reservoir for aspiration or injection procedure)
• 75809 (Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation)
• 62370 (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)).

Here’s why: It is common for a provider to need to abstract medicine from the pump, place it back, and reprogram. The removal, replacement, and reprogramming of the pump with the same solution still constitutes a “refill” service. The work involved in removing the contents of the pump and then refilling the pump would meet the relative value unit (RVU) requirement of placing new medicine during a scheduled refill.