Intrathecal Pump Billing and Coding

Which code do you bill at an intrathecal pump visit?

The code depends on what was done at the visit. A refill alone is 95990, or 95991 with physician skill. Analysis is 62367 without reprogramming and 62368 with it. Analysis with reprogramming and refill is 62369, or 62370 with physician skill, and those two already include the refill.

• Refill only: 95990, or 95991 when physician skill is required
• Analysis without reprogramming or refill: 62367
• Analysis with reprogramming: 62368
• Analysis with reprogramming and refill: 62369, or 62370 when physician skill is required
• Do not bill 95990 or 95991 with 62369 or 62370, since those codes already include the refill

How are intrathecal pump drugs billed?

Drugs placed in the pump are billed with their HCPCS codes in the correct units for the amount used. Medicare requires the JW modifier for discarded drug from a single-dose container, or JZ when none was discarded. Drug units that do not match the documented amount are a common reason pump claims are denied.