Neurosurgery Coding Alert

Question: Our neurosurgeon occasionally uses nonepidural continuous infusion pumps. Is there any way to code for placing the device?

Minnesota Subscriber

Answer: You may be able to code the infusion separately, but certain payers do not consider the service payable, so you-ll have to do some research before reporting "pain pump" placement.

The basics: Continuous infusion pumps provide a steady stream of local anesthetic to an area singled out for pain relief. When your neurosurgeon treats a patient with a pain pump for medication delivery to other non-spinal locations, choose the code based on the nerve the neurosurgeon targets with the continuous infusion by catheter.

Alert: Many payers, both private and federal, will not reimburse for the pain pump codes, citing a lack of evidence that they are effective. If you are placing one of these pumps in a patient, get him to sign an advance beneficiary notice (ABN). The ABN should explain to the patient that the payer may not cover the pain pump placement, and the patient will have to pick up any portion of the service left unpaid.