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The CPT® Code 95990 refers to the procedure of refilling and maintaining an implantable pump or reservoir used for drug delivery, specifically in spinal (intrathecal or epidural) or brain (intraventricular) applications. This procedure is essential for ensuring the continuous or intermittent infusion of medication over an extended period. As the drug is delivered through the pump, it is necessary to periodically refill the pump or reservoir to maintain its functionality and effectiveness. During the refill process, maintenance tasks are also performed to ensure the device operates correctly. Additionally, an electronic analysis of the pump may be conducted, which involves using an interrogation device to assess various parameters of the pump's operation. This analysis checks the reservoir status, alarm status, and drug flow rates to confirm that they are functioning within normal limits. The procedure begins with the verification of the drug received from the pharmacy, along with the corresponding prescription and patient information. An external needle is then utilized to inject the medication into the pump or reservoir through a self-septum, allowing for a sterile and efficient refill process. It is important to note that if the refilling and maintenance require the expertise of a physician or qualified healthcare professional, the appropriate code to use is 95991.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 95990 is indicated for patients who require long-term drug delivery via an implantable pump or reservoir. The following conditions may warrant this procedure:
The procedure for refilling and maintaining an implantable pump or reservoir involves several critical steps to ensure the safe and effective delivery of medication.
After the refilling and maintenance procedure is completed, the patient may be monitored for a short period to ensure there are no immediate complications or adverse reactions to the medication. It is important for the healthcare provider to provide the patient with instructions regarding any post-procedure care, including signs of potential complications to watch for, such as infection at the injection site or changes in pain levels. Follow-up appointments may be scheduled to assess the effectiveness of the medication and the overall function of the implantable pump or reservoir.
| Short Descr | SPIN/BRAIN PUMP REFIL & MAIN | Medium Descr | REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN | Long Descr | Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 5 - Incident To 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) | 0 - 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 | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | O1C - Enteral and parenteral | MUE | 1 | CCS Clinical Classification | 8 - Other non-OR or closed therapeutic nervous system procedures |
| 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). | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | LT | Left side (used to identify procedures performed on the left side of the body) | 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 |
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| 2012-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Medium description changed. |
| 2010-01-01 | Changed | Code description changed. |
| 2004-01-01 | Changed | Code description changed. |
| 2003-01-01 | Added | First appearance in code book in 2003. |
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