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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; with laminectomy

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 62351 involves the implantation, revision, or repositioning of a tunneled intrathecal or epidural catheter, specifically for the purpose of long-term medication administration. This procedure is performed in conjunction with a laminectomy, which is a surgical operation that involves the removal of a portion of the vertebral bone called the lamina. The primary goal of this procedure is to facilitate the delivery of medications directly into the intrathecal or epidural space, allowing for effective pain management or treatment of other conditions requiring long-term medication therapy. The process begins with the preparation of the skin and the administration of local anesthesia, followed by the insertion of a spinal needle to access the targeted space. Once the catheter is positioned correctly, it is tunneled subcutaneously to minimize discomfort and is then connected to an external pump or an implantable reservoir for medication delivery. The inclusion of a laminectomy in this procedure allows for enhanced access to the spinal canal, which may be necessary for certain patients based on their anatomical or clinical needs. This comprehensive approach ensures that the catheter is securely placed and optimally positioned for effective medication administration.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 62351 is indicated for patients requiring long-term medication administration via an intrathecal or epidural catheter. The specific indications for this procedure may include:

  • Chronic Pain Management Patients suffering from chronic pain conditions that do not respond adequately to oral medications may benefit from this procedure, as it allows for targeted delivery of analgesics directly to the spinal cord.
  • Neuropathic Pain Conditions characterized by nerve pain, such as complex regional pain syndrome or postherpetic neuralgia, may warrant the use of an intrathecal or epidural catheter for effective treatment.
  • Spasticity Management Patients with spasticity due to neurological conditions may require medication administration to manage muscle tone and improve mobility.
  • Oncology Patients Patients with cancer may require pain management strategies that include the use of intrathecal or epidural catheters for the administration of opioids or other analgesics.

2. Procedure

The procedure for CPT® Code 62351 involves several detailed steps to ensure proper implantation, revision, or repositioning of the catheter. The steps are as follows:

  • Step 1: Preparation The patient is positioned appropriately, and the skin over the catheter placement site is cleansed with an antiseptic solution. Local anesthesia is administered to minimize discomfort during the procedure.
  • Step 2: Incision and Exposure A surgical incision is made over the catheter placement site, extending down to the spinous processes. The surrounding muscle is carefully retracted to expose the lamina and facet joint.
  • Step 3: Laminectomy A bone drill is utilized to remove part or all of the lamina, providing access to the intrathecal or epidural space. This step is crucial for facilitating the placement of the catheter.
  • Step 4: Catheter Placement The intrathecal or epidural catheter is implanted, revised, or repositioned as necessary. The catheter is threaded through the spinal needle and advanced to the appropriate level for medication administration.
  • Step 5: Tunneling and Connection The catheter is tunneled subcutaneously, approximately 5-10 cm away from the insertion site, and is then secured with sutures. It is connected to an external pump or an implantable reservoir for medication delivery.
  • Step 6: Closure The surgical wound is closed in layers, ensuring proper healing and minimizing the risk of infection.

3. Post-Procedure

After the procedure, patients are typically monitored for any immediate complications, such as infection or bleeding. Post-procedure care may include pain management, monitoring for signs of catheter malfunction, and ensuring the proper functioning of the external pump or implantable reservoir. Patients may be advised on activity restrictions and signs of complications to watch for during the recovery period. Follow-up appointments are essential to assess the effectiveness of the catheter placement and to make any necessary adjustments to the medication regimen.

Short Descr IMPLANT SPINAL CANAL CATH
Medium Descr IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/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; with laminectomy
Status Code Active Code
Global Days 090 - Major Surgery
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) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met.
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
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 3 - Laminectomy, excision intervertebral disc
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).
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.
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).
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.
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.
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.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
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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