Neurosurgery Coding Alert

Question: Our neurosurgeon removed an implanted pain pump and catheter from. a patient who had a pain pump implanted three weeks ago. When the abdominal wound was opened, some fluid was found in the cavity which was sent for culture. Please advice for the coding of the pain pump removal. Can we also bill for the wound culture? Can we bill for the swab obtained from the wound fluid and sending it for laboratory culture?

Florida Subscriber

Answer: Pain pumps generally are implanted for long-term pain management and often are not removed very frequently. In a rare instance of the patient ceasing to respond to the pain pump, the surgeon may decide to remove the pain pump and the catheter. However, the catheter or the pump itself may develop a problem and need to be replaced, such as in the setting of postoperative infection.

You may report code 62365 (Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion) for removal of the pump and 62355 (Removal of previously implanted intrathecal or epidural catheter)-51 (Multiple procedures) for removal of the catheter.  You should also append the 78 modifier since the procedure is being performed within the global period.

There is no separate charge for swabbing the wound and sending the sample to the laboratory for culture. You do not report any separate code for this service.