2025 CPT code 62368
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Electronic analysis of a programmable, implanted pump for intrathecal or epidural drug infusion, including evaluation of reservoir status, alarm status, and drug prescription status; with reprogramming.
Modifiers may be applicable depending on the circumstances of the service. Refer to the CPT guidelines for appropriate modifier use. Examples may include modifiers 52 (reduced services), 59 (distinct procedural service), or others as deemed necessary based on clinical context.
Medical necessity for this procedure is established when there is a clinical indication for the reprogramming or analysis of an implanted drug infusion pump, such as malfunctioning equipment, altered pain levels, changes in medication needs, or changes in patient condition that require adjustments to the medication delivery.
The clinical responsibility for this procedure may involve physicians, physician assistants, nurses, or physical therapists. The provider is responsible for analyzing the pump's performance using electronic monitoring, interpreting the data (infusion rate, residual volume, alarm status), and reprogramming the pump as medically necessary.
In simple words: This medical code covers checking and adjusting a small pump implanted in the body to deliver medicine for pain or other conditions. The doctor uses a computer to check the pump's settings, how much medicine is left, and if there are any alarms.If necessary, they will change the pump's settings to adjust the medicine flow.
This CPT code encompasses the electronic analysis of a programmable, implanted pump designed for intrathecal or epidural drug infusion.The analysis includes a comprehensive evaluation of the reservoir status, alarm status, and the current drug prescription settings. The procedure also involves reprogramming the pump as needed.Intrathecal refers to the space between the spinal cord and its protective sheath, while epidural refers to the outer part of the spinal canal. The pump, or reservoir, is a device that stores and delivers medication such as pain medication or chemotherapy.
Example 1: A patient with chronic back pain from a previous injury has an implanted epidural pump delivering pain medication. The pump's performance is evaluated and the infusion rate is adjusted to better manage the patient's pain levels., A cancer patient with an intrathecal pump delivering chemotherapy experiences a decrease in medication delivery. The provider analyzes the pump, identifies a malfunction, and reprograms the device to restore the correct infusion rate., A patient with an implanted pump experiences an alarm. A healthcare provider performs an electronic analysis of the pump to identify the cause of the alarm. After determining the cause, the provider reprograms the device to address the malfunction.
* Detailed patient history and clinical indication for the implanted pump.* Pre-procedure assessment of the patient's condition.* Electronic pump analysis data, including infusion rate, residual volume, and alarm status.* Documentation of any reprogramming performed, including the changes made to the pump's settings.* Post-procedure assessment of the patient's response to the procedure.* Any relevant imaging studies.
** Always consult the most recent CPT codebook and payer-specific guidelines for the most up-to-date information on coding, billing, and reimbursement for this procedure.Accurate documentation is crucial for proper coding and payment.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- RVU: This information is not provided in the source and requires reference to the most recent CMS relative value units (RVUs) data.The RVUs will vary based on geographic location and facility type (non-facility vs. facility).
- Global Days : The global period for this procedure is not specified and needs to be determined by referring to additional guidelines and local payment policies.
- Payment Status: Active
- Modifier TC rule: The application of a Technical Component (TC) modifier would depend on the specific details of the service rendered and should be assessed according to the guidelines.
- Fee Schedule : This information is not provided and is subject to change based on payer and location. This information requires reference to historical fee schedules from various payers.
- Specialties:Anesthesiology, Pain Management, Neurosurgery, Oncology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgery Center