On q pain management system

We use this system by inserting the tube in the incision and then the patient pulls it out with 5-7 days. I have not been sucessful in finding the proper CPT, if there is one. Help!

on q pain management system

Are you doing this as part of the surgery? Or, is it pain management for chronic pain?

Tell us the situation in which you provide the service.

On Q pain pump

The insertion of a pain pump/pain catheter is not separately reportable by the operating surgeon if placed during the operative session at the surgical site. If an anesthesiologist places the pain pump/catheter the anesthesiologist may report as part of his/her anesthesia services. Post operative pain management is included in the surgical procedure.

Mary LeGrand, RN,MA, CCS-P, CPC
KarenZupko & Associates, Inc.

On Q Pain Pump Code

We use 11981 with a 59 and we do have some insurance carriers that pay this.

On Q pain management pump

Remember, just because you got paid on an incorrectly coded claim doesn't make it right. Placement of this or any other activity to facilitate postop pain management is not separately billable for the surgeon.

Kim Pollock, RN, MBA, CPC
KarenZupko & Associates, Inc.
www.karenzupko.com

On Q Pain Pump

Thank you for your in put. I will research this further. Where is the documentation or bundling on this issue can you assist there?

on Q Pain Pump

I think there are two places to find this, although it isn't explicit "No pain pump insertion fee."

In the Medicare Claims Processing Manual, Chapter 12, Section 40, it says that pain management is part of the global fee.

Ditto for the introductory chapter for surgery in the NCCI manual.

Q pain pump

So if it is not explicit? How can we determine if we can charge for this or not? I will research it further and certainly will abide by any determinations. I did not say Medicare pays, I did say some carriers do pay. The code I got was from the Rep for the pain pump a while back. I will talk to the Q Pain Pump Rep and ask him for additional information regarding the coding on this. So I will continue my research. But still confused why I was told by the person that responded that we cannot bill for it period.... without her providing the documentation when stating that?? I still need some help with this?

I always appreciate your assistance, and will make the determination when documention is found.

I will keep you posted, if there are any new findings regarding this please let me know.
I will share with you what I find on this.


Thanks

On Q pain pump

Refer to the May 1999 CPT Assistant, page 8. In summary it says pain mgmt services may be billed by someone other than the physician performing the surgical services. Furthermore, the physician specialty societies (eg, AAOS, AANS, ACS) say this placement of pain management devices for control of postop pain is included for the primary surgeon and not separately billable. These are the CPT coding rules - and we first follow CPT coding rules.

Payor rules may allow reimbursement just as you've noted. But again the coding rules override the fact that the code you billed made it through the payor's edits.

Never rely on coding advice from a vendor as, in general, they’ve been known to be wrong (and their motive is to sell their product...painting customers a "rosey" reimbursement picture makes the product more enticing).

Kim Pollock, RN, MBA, CPC
KarenZupko & Associates, Inc.
www.karenzupko.com

Q Pain Pump

Thank you for your information I will bring this to the office and the Surgeons attention. I appreciate your research. This is what is good about this web site..we can find out "stuff".