Per July 2008 CPT Assistant:
Question: What is the appropriate code to use for reporting implanted pump catheter dye studies? The patient is not getting pain relief, and an intrathecal catheter is evaluated for dislodgement, discontinuity, or kinking. Contrast is injected through the catheter with fluoroscopic guidance to identify a potential problem.
Answer: It is appropriate to report code 75809, Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation, for the radiologic supervision and interpretation (RSI) portion of such a procedure to evaluate for shunt catheter patency or leakage. This code can be used for evaluation of a variety of similar and related nonvascular shunt catheters and devices, and requires the injection of contrast. Occasionally, evaluation for discontinuity is performed using plain radiography or CT imaging, without catheter contrast injection. In such cases, the service should be reported using appropriate radiography or CT codes describing which anatomical areas were imaged (eg, brain, neck, chest, and/or abdomen).
Implanted pump catheter dye studies typically require an injection component and an RSI component; therefore, it would also be appropriate for the physician performing the injection to report code 61070, Puncture of shunt tubing or reservoir for aspiration or injection procedure, to describe the injection service itself.