lcole7465
Expert
The provider wants to bill for a catheter access study: 61070/75809 along with a pump adjustment: 62368. From the documentation, I'm not really seeing that a separate adjustment was done for the bolus... Any insight would be greatly appreciated.
The providers note reads:
The area overlying the intrathecal pump was identified using fluoroscopy in the AP view. This was then followed by prepping and draping the skin in a sterile fashion using chlorhexidine and then placement of the template overlying the pump. The catheter access port was accessed using 25G needle. Clear cerebrospinal fluid was then aspirated from the intrathecal catheter confirming that the catheter was patent. Approximately 3 mL was siphoned off. This was then followed by injection of 2 mL of non-ionic contrast dye with spread of the contrast being visualized under live fluoroscopy to go through the catheter and throughout the entire length of the catheter, which was visualized to be within the intrathecal space and completely patent without any evidence of disconnections, kinking, or granuloma formation; confirming that the entire system was functioning appropriately. This was flushed by 3 mL of preservative-free normal saline.
Then the pump was reprogrammed to bridge bolus the medication from the catheter access port to the catheter tip over a period of 12 minutes. The patient tolerated this procedure well and was taken back to the recovery room in stable condition.
The providers note reads:
The area overlying the intrathecal pump was identified using fluoroscopy in the AP view. This was then followed by prepping and draping the skin in a sterile fashion using chlorhexidine and then placement of the template overlying the pump. The catheter access port was accessed using 25G needle. Clear cerebrospinal fluid was then aspirated from the intrathecal catheter confirming that the catheter was patent. Approximately 3 mL was siphoned off. This was then followed by injection of 2 mL of non-ionic contrast dye with spread of the contrast being visualized under live fluoroscopy to go through the catheter and throughout the entire length of the catheter, which was visualized to be within the intrathecal space and completely patent without any evidence of disconnections, kinking, or granuloma formation; confirming that the entire system was functioning appropriately. This was flushed by 3 mL of preservative-free normal saline.
Then the pump was reprogrammed to bridge bolus the medication from the catheter access port to the catheter tip over a period of 12 minutes. The patient tolerated this procedure well and was taken back to the recovery room in stable condition.