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Official Description

Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 62350 refers to the procedure of implantation, revision, or repositioning of a tunneled intrathecal or epidural catheter specifically for long-term medication administration. This procedure is performed without the need for a laminectomy, which is a surgical procedure that involves the removal of a portion of the vertebrae. The primary purpose of this procedure is to facilitate the delivery of medications, such as analgesics or anesthetics, directly into the intrathecal or epidural space, allowing for effective pain management or treatment of other conditions. During the procedure, the skin over the insertion site is first cleansed with an antiseptic solution, and a local anesthetic is administered to minimize discomfort. A spinal needle is then carefully inserted into the skin and advanced into the targeted intrathecal or epidural space. Following this, a catheter is threaded through the needle, with its tip advanced to the appropriate anatomical level for optimal medication delivery. The catheter is subsequently tunneled subcutaneously to a location approximately 5-10 cm from the insertion site, where it is secured with sutures. The catheter is then connected to an external pump or an implantable reservoir or infusion pump, ensuring that the medication can be administered continuously or as needed. In cases where revision or repositioning of the catheter is necessary, the existing catheter is exposed, and adjustments are made to ensure proper function and placement, all while maintaining the integrity of the surrounding tissues.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 62350 is indicated for patients requiring long-term medication administration via an intrathecal or epidural catheter. The specific indications for this procedure include:

  • Chronic Pain Management Patients suffering from chronic pain conditions that are not adequately controlled by oral medications may benefit from this procedure, allowing for targeted delivery of analgesics.
  • Neuropathic Pain Conditions such as neuropathic pain syndromes may require direct medication administration to the spinal area for effective relief.
  • Spasticity Management Patients with spasticity due to neurological conditions may require intrathecal baclofen therapy, which necessitates the use of an implanted catheter for medication delivery.
  • Oncology Patients Patients with cancer may require pain management strategies that include the use of intrathecal or epidural catheters for effective control of pain associated with their condition.

2. Procedure

The procedure for CPT® Code 62350 involves several key steps, which are detailed as follows:

  • Step 1: Preparation The procedure begins with the preparation of the patient, which includes cleansing the skin over the intended insertion site with an antiseptic solution to reduce the risk of infection. A local anesthetic is then injected to ensure the patient experiences minimal discomfort during the procedure.
  • Step 2: Insertion of Spinal Needle A spinal needle is carefully inserted through the skin and advanced into the intrathecal or epidural space. This step is critical as it allows access to the area where the catheter will be placed.
  • Step 3: Catheter Placement Once the spinal needle is in the correct position, a catheter is threaded through the needle. The tip of the catheter is advanced cephalad to the selected anatomical level, which is determined based on the specific needs for pain control or medication administration.
  • Step 4: Tunneling the Catheter After the catheter is positioned, it is tunneled subcutaneously approximately 5-10 cm away from the insertion site. This tunneling helps to secure the catheter and protect it from external trauma.
  • Step 5: Securing the Catheter The catheter is then secured in place with sutures to prevent movement and ensure stability. This is an important step to maintain the integrity of the catheter placement.
  • Step 6: Connection to Pump Finally, the catheter is connected to an external pump or an implantable reservoir or infusion pump, which will facilitate the long-term administration of medication as prescribed.
  • Step 7: Revision or Repositioning (if applicable) If the procedure involves revision, the existing catheter is exposed, and the connection site at the reservoir or pump is inspected. Adjustments may include disconnecting, trimming, and reconnecting the catheter. For repositioning, the catheter is disconnected and manipulated to a different site within the intrathecal or epidural space, then secured and reconnected to the pump or reservoir.

3. Post-Procedure

Post-procedure care for patients undergoing the implantation, revision, or repositioning of a tunneled intrathecal or epidural catheter includes monitoring for any signs of complications such as infection, catheter displacement, or adverse reactions to the medication administered. Patients may be advised to avoid strenuous activities and to keep the insertion site clean and dry. Follow-up appointments are typically scheduled to assess the effectiveness of the medication delivery and to make any necessary adjustments to the catheter or medication regimen. It is essential for healthcare providers to educate patients on signs of potential complications and the importance of adhering to follow-up care to ensure optimal outcomes.

Short Descr IMPLANT SPINAL CANAL CATH
Medium Descr IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM
Long Descr Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy
Status Code Active Code
Global Days 010 - Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 5 - Insertion of catheter or spinal stimulator and injection into spinal canal
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
GC This service has been performed in part by a resident under the direction of a teaching physician
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
KX Requirements specified in the medical policy have been met
LT Left side (used to identify procedures performed on the left side of the body)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
SG Ambulatory surgical center (asc) facility service
X2 Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2001-01-01 Changed Code description changed.
1996-01-01 Added First appearance in code book in 1996.
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