Wiki coding on-q pain pump insertion

Create Wiki
N

nc_coder

Expert
Messages
300
Location
Iron Station, NC
Best answers
0
One of my physicians turned in a charge for insertion of an On-Q pump with a Laparoscopic Hernia Repair. Does anyone know if I can bill for this and if so, how?:confused:
 
coding for pain pumps

We have been told by the On-Q rep to use unlisted codes. For example, if we place an On-Q with an inguinal hernia repair we would bill 49999 for the pain pump. Most insurance companies will pend the claim for review. It took an average of 45 days to get the claim paid. Cigna has advised us that 11981 is more appropriate than an unlisted code. Needless to say we are billing 11981 to Cigna.
 
on q pain pump insertion

Here are the codes that are used for the pump inserts

64416 – brachial plexus
64446 – sciatic nerve
64448 – femoral nerve
64449 – lumbar plexus
76942 – ultrasound guided (different revenue code) (no separate payment, it is included in codes above
 
racosta, has Cigna paid the 11981? What other ins companies have you billed it to and have they paid it? I have had some ins companies pay the 49999 after sending in documentation and appealing it. Some BCBS and some of the no name private insurances. Thanks
 
racosta said:
We have been told by the On-Q rep to use unlisted codes. For example, if we place an On-Q with an inguinal hernia repair we would bill 49999 for the pain pump. Most insurance companies will pend the claim for review. It took an average of 45 days to get the claim paid. Cigna has advised us that 11981 is more appropriate than an unlisted code. Needless to say we are billing 11981 to Cigna.
Click to expand...
As a payer, we have chosen to adopt CPT ciode 11981 for the On-Q pain pump. My question is this; How did Cigna communicate to you as a provider that they required this code when billing an On-Q? As a rule, we don't tell our providers how to bill, however, if there is a way to communicate this to our network of providers, I would be most grateful for any direction anyone can give. Thanks for your help!!!
 
kknapp said:
Here are the codes that are used for the pump inserts

64416 – brachial plexus
64446 – sciatic nerve
64448 – femoral nerve
64449 – lumbar plexus
76942 – ultrasound guided (different revenue code) (no separate payment, it is included in codes above
Click to expand...

Thanks for your reply. I have researched these codes. I don't think any of these would be what I am looking for. My physicians use this pump with abdominal surgeries and state it was placed in the "preperitoneal space". I didn't see any mentioned above that would fit that description.
Thanks again for your help.
 
I have read that 11981 doesn't "accurately the describe the service" - it has nothing to do with pain control. I wish I could find that article. That's interesting that Cigna uses it.....hmmmm.
My plastics doc wanted to bill it and I believe I found the article in a plastics magazine that said do not use... even though it's a pain to bill the unlisted code, that's the way we've been doing it.....
 
coding on a q pain pump removal

I am looking for any documentation to determine when it would be appropriate to bill for q pain pump removal by a physician or PA.

Specifically is this usually only billed when a patient is given some type of sedation or can it be appropriately billed at any time?
 
You must log in or register to reply here.
Top