Neurosurgery Coding Alert

Question: Which code(s) are appropriate to report intrathecal baclofen?

Michigan Subscriber

Answer: The patient receives intrathecal baclofen injections from an implantable pain pump, which consists of the pump itself, a catheter, and an access port.

Depending on the type of pump, you may report implantation using one of three codes: For a programmable pump, which automatically controls the dose, use 62362 (Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming). For a non-programmable pump, report 62631. Code 62360 identifies a simple subcutaneous reservoir.

Report catheter placement separately using 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; without laminectomy) or 62351 (... with laminectomy), as appropriate.

You must fill pain pumps through a self-sealing rubber septum. The physician inserts a needle under the skin and through the septum to replenish the drug supply. To report this service, use 96530 (Refilling and maintenance of implantable pump or reservoir) with the appropriate HCPCS J code for the baclofen (J0475, Injection, baclofen, 10 mg).

You may report reprogramming of programmable pumps (to adjust dosage) with 62368 (Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion [including evaluation of reservoir status, alarm status, drug prescription status]; with reprogramming) but not at the same time the surgeon initially implants the pump. For electronic analysis of the pump without reprogramming, you should report 62367.