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The CPT® Code 62369 refers to the electronic analysis of a programmable, implanted pump used for intrathecal or epidural drug infusion. This procedure involves a comprehensive evaluation of the pump's functionality through electronic means. The process begins with establishing a connection between the implanted pump and an interrogation device, which is designed to extract critical data regarding the pump's operational status. Key parameters assessed during this analysis include the reservoir status, which indicates the amount of medication remaining in the pump, the alarm status that alerts the user to any potential issues, and the drug prescription status that confirms the correct medication is being delivered. During the evaluation, a technician or physician reviews the data obtained from the interrogation device to ensure that all parameters are functioning within acceptable limits. If any discrepancies are found, reprogramming of the pump may be necessary. This reprogramming is conducted using a telemetry device, allowing for adjustments to be made remotely. Adjustments can include changes to alarm settings and drug flow rates to optimize the delivery of medication. After reprogramming, the new settings are verified with the interrogation device to confirm that they have been successfully implemented. Additionally, the procedure may involve refilling the pump with medication, ensuring that the patient continues to receive the necessary treatment. A written report detailing the findings of the evaluation, any reprogramming performed, and the refill status is generated as part of this process. It is important to note that different CPT codes apply depending on whether the pump is simply analyzed, reprogrammed, or refilled, with specific codes designated for each scenario to ensure accurate billing and documentation.
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The procedure associated with CPT® Code 62369 is indicated for patients who have a programmable, implanted intrathecal or epidural drug infusion pump. The following conditions may warrant the electronic analysis and reprogramming of the pump:
The procedure for CPT® Code 62369 involves several critical steps to ensure the proper functioning of the implanted pump:
After the procedure associated with CPT® Code 62369, patients may be monitored for any immediate reactions to the adjustments made to the pump. It is essential to ensure that the pump is functioning correctly and that the patient is receiving the appropriate dosage of medication. Patients should be advised to report any unusual symptoms or alarm notifications from the pump. Follow-up appointments may be scheduled to reassess the pump's performance and make any further adjustments if necessary. Additionally, the written report generated during the procedure serves as a critical document for ongoing patient management and should be included in the patient's medical records for future reference.
| Short Descr | ANAL SP INF PMP W/REPRG&FILL | Medium Descr | ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL | Long Descr | Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 8 - Other non-OR or closed therapeutic nervous system procedures |
| GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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 | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 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. | 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. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GP | Services delivered under an outpatient physical therapy plan of care | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | QW | Clia waived test | RT | Right side (used to identify procedures performed on the right side of the body) | SA | Nurse practitioner rendering service in collaboration with a physician | 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 |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2012-01-01 | Added | Added |
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