Neurology & Pain Management Coding Alert

Question: Encounter notes indicate that the PM physician performed electronic analysis an intrathecal drug pump. During the encounter, they also evaluated the reservoir status and reviewed prescriptions. Is there a way to report the reservoir evaluation and prescription review separately from the analysis?

Idaho Subscriber

Answer: No, you cannot report reservoir evaluation or prescription review separately. You will also need to get some more information before you can choose the most accurate CPT^® code for this claim.

Ask yourself: There’s a few questions to keep in mind as you review the notes:

• Did the provider perform a refill in addition to the analysis?
• Did the provider perform reprogramming in addition to the analysis?
• If the provider performed reprogramming and refill in addition to the analysis, did it require the skill of a physician or other qualified healthcare professional (QHP)?

Then, choose one of the following codes for the drug pump analysis:

• 62367 (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)
• 62368 (… with reprogramming)
• 62369 (… with reprogramming and refill)
• 62370 (… with reprogramming and refill (requiring skill of a physician or other qualified health care professional)).