American Society of Regional Anesthesia and Pain Medicine August 2018 - 31
Table 2: Current Procedural Terminology procedure codes.
Procedure
Code
Code description
2015 Medicare
National averagea
Physician
office
Trialb,c
Facility
62311
Injection(s) of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, or
other solution), not including neurolytic substances, including needle or catheter placement, contrast
for localization when performed, epidural or subarachnoid, and lumbar or sacral (caudal)
$225
$92
62319
Injection(s), including indwelling catheter placement, continuous infusion, or intermittent bolus, of
diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution),
not including neurolytic substances, including contrast for localization when performed, epidural or
subarachnoid, and lumbar or sacral (caudal)
$170
$99
62350
Implantation, revision, or repositioning of tunneled intrathecal or epidural catheter for long-term medication
administration via an external pump or implantable reservoir, infusion, or pump, without laminectomy
N/A
$401
62351
Implantation, revision, or repositioning of tunneled intrathecal or epidural catheter for long-term medication
administration via an external pump or implantable reservoir, infusion, or pump, with laminectomy
N/A
$780
Implantation or
replacement of pump
62362
Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump,
including preparation of pump, with or without programming
N/A
$415
Removal of catheter
or pump
62355
Removal of previously implanted intrathecal or epidural catheter
N/A
$280
62365
Removal of subcutaneous reservoir or pump previously implanted for intrathecal or epidural infusion
N/A
$309
Fluoroscopy for
catheter placement
and injection
77003 or
77003-26
Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or
therapeutic injection procedures (epidural or subarachnoid)
$86
$86
Drugd
J2274
Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg
ASP+6%
-
Follow-up refill,
analysis, or
reprogramminge
62367
Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion
(includes evaluation of reservoir status, alarm status, and drug prescription status), without
reprogramming or refill
$41
$26
62368
Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes
evaluation of reservoir status, alarm status, and drug prescription status), with reprogramming
$57
$36
62369
Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes
evaluation of reservoir status, alarm status, and drug prescription status), with reprogramming and refill
$123
-
62370
Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion
(includes evaluation of reservoir status, alarm status, and drug prescription status), with
reprogramming and refill, requiring the skill of a physician or other qualified health care professionalf
$129
$48
95990
Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal,
epidural) or brain (intraventricular), includes electronic analysis of pump, when performed
$73
-
95991
Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal,
epidural) or brain (intraventricular), includes electronic analysis of pump, when performed, requiring
the skill of a physician or other qualified health care professional
$95
$31
Catheter dye study
61070
Puncture of shunt tubing or reservoir for aspiration or injection procedure
N/A
$60
Evaluation and
management
99211-
99215
Office or other outpatient visit
$20-
$145
$9-$110
Implantation or
revision of catheter
Medicare national average payment is determined by multiplying the sum of the three relative value units by the conversion factor. The conversion factor for CY 2015 was $35.7547 through March
31, 2015, in accordance with the CMS-1612-FC.12 Note: Any applicable coinsurance, deductible, and other amounts that are patient obligations are included in the payment amount shown. Also, final
physician payment is adjusted by the Geographic Practice Cost Indices.
b
Per the Current Procedural Terminology (CPT) Manual, CPT code 62311 is used for needle injection or when a catheter is placed to administer one or more injections on a single calendar day. CPT
code 62319 is used when the catheter is left in place to deliver the agent continuously or intermittently for more than a single calendar day. Both CPT codes (62311 and 62319) include temporary
catheter placement.
c
The Centers for Medicare and Medicaid Services has published that reporting CPT code 77003 is prohibited because 62311 and 62319 are already valued to include fluoroscopic guidance.13
d
Reimbursement for intrathecal drugs varies considerably based on state-specific provider guidelines.
e
The refill, analysis, and reprogramming codes are used only for follow-up services and are not to be used at the time of implantation.
f
Code 62369 is assigned when the pump is interrogated, reprogrammed, and refilled by ancillary staff (eg, nurse under physician supervision in the office). As defined for 2014, code 62370 is
used when the pump is interrogated, reprogrammed, and refilled by a physician or "other qualified health care professional." The American Medical Association defines "other qualified health
care professional" as an individual who performs professional services within the scope of practice and is able to bill their services independently (eg, nurse practitioner). However, because payer
interpretations for use of code 62370 may vary, check with the individual payer on the types of practitioners who may assign and bill for codes 62370 and 62369.
a
American Society of Regional Anesthesia and Pain Medicine
2018
31
Table of Contents for the Digital Edition of American Society of Regional Anesthesia and Pain Medicine August 2018
American Society of Regional Anesthesia and Pain Medicine August 2018 - 1
American Society of Regional Anesthesia and Pain Medicine August 2018 - 2
American Society of Regional Anesthesia and Pain Medicine August 2018 - 3
American Society of Regional Anesthesia and Pain Medicine August 2018 - 4
American Society of Regional Anesthesia and Pain Medicine August 2018 - 5
American Society of Regional Anesthesia and Pain Medicine August 2018 - 6
American Society of Regional Anesthesia and Pain Medicine August 2018 - 7
American Society of Regional Anesthesia and Pain Medicine August 2018 - 8
American Society of Regional Anesthesia and Pain Medicine August 2018 - 9
American Society of Regional Anesthesia and Pain Medicine August 2018 - 10
American Society of Regional Anesthesia and Pain Medicine August 2018 - 11
American Society of Regional Anesthesia and Pain Medicine August 2018 - 12
American Society of Regional Anesthesia and Pain Medicine August 2018 - 13
American Society of Regional Anesthesia and Pain Medicine August 2018 - 14
American Society of Regional Anesthesia and Pain Medicine August 2018 - 15
American Society of Regional Anesthesia and Pain Medicine August 2018 - 16
American Society of Regional Anesthesia and Pain Medicine August 2018 - 17
American Society of Regional Anesthesia and Pain Medicine August 2018 - 18
American Society of Regional Anesthesia and Pain Medicine August 2018 - 19
American Society of Regional Anesthesia and Pain Medicine August 2018 - 20
American Society of Regional Anesthesia and Pain Medicine August 2018 - 21
American Society of Regional Anesthesia and Pain Medicine August 2018 - 22
American Society of Regional Anesthesia and Pain Medicine August 2018 - 23
American Society of Regional Anesthesia and Pain Medicine August 2018 - 24
American Society of Regional Anesthesia and Pain Medicine August 2018 - 25
American Society of Regional Anesthesia and Pain Medicine August 2018 - 26
American Society of Regional Anesthesia and Pain Medicine August 2018 - 27
American Society of Regional Anesthesia and Pain Medicine August 2018 - 28
American Society of Regional Anesthesia and Pain Medicine August 2018 - 29
American Society of Regional Anesthesia and Pain Medicine August 2018 - 30
American Society of Regional Anesthesia and Pain Medicine August 2018 - 31
American Society of Regional Anesthesia and Pain Medicine August 2018 - 32
American Society of Regional Anesthesia and Pain Medicine August 2018 - 33
American Society of Regional Anesthesia and Pain Medicine August 2018 - 34
American Society of Regional Anesthesia and Pain Medicine August 2018 - 35
American Society of Regional Anesthesia and Pain Medicine August 2018 - 36
American Society of Regional Anesthesia and Pain Medicine August 2018 - 37
American Society of Regional Anesthesia and Pain Medicine August 2018 - 38
American Society of Regional Anesthesia and Pain Medicine August 2018 - 39
American Society of Regional Anesthesia and Pain Medicine August 2018 - 40
American Society of Regional Anesthesia and Pain Medicine August 2018 - 41
American Society of Regional Anesthesia and Pain Medicine August 2018 - 42
http://www.brightcopy.net/allen/asra/18-04
http://www.brightcopy.net/allen/asra/18-3
http://www.brightcopy.net/allen/asra/18-2
http://www.brightcopy.net/allen/asra/18-1
http://www.brightcopy.net/allen/asra/17-4
http://www.brightcopy.net/allen/asra/17-3
http://www.brightcopy.net/allen/asra/17-2
http://www.brightcopy.net/allen/asra/17-1
http://www.brightcopy.net/allen/asra/16-4
http://www.brightcopy.net/allen/asra/16-3
http://www.brightcopy.net/allen/asra/16-2
http://www.brightcopy.net/allen/asra/16-1
http://www.brightcopy.net/allen/asra/15-4
http://www.brightcopy.net/allen/asra/15-3
https://www.nxtbook.com/allen/asra/15-2
https://www.nxtbook.com/allen/asra/15-1
https://www.nxtbookmedia.com