General Surgery Coding Alert

Question: Our surgeon inserted a paraspinal On-Q pump for pain control for multiple rib fractures. We've been told to report 21800 for each rib. But the surgeon placed the pump in the area to cover multilevel rib fractures, so I'm thinking 62350 is more appropriate -- what do you think?Minnesota SubscriberAnswer: You'll need to follow payer guidelines -- which may not match manufacturer billing advice -- for the On-Q pain pump. Many payers will not pay separately for inserting the pump because the work is nominal and they consider it part of the surgical procedure.Although 21800 (Closed treatment of rib fracture, uncomplicated, each) would be appropriate for the reduction, which might include pain pump placement, using the code for the pain pump alone would not be appropriate.Nor should you report 62350 (Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; [...]