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Revision of intrathecal drug pump

Date: Sep 24, 2012

Question:

Procedure: Revision of intrathecal drug delivery pump. Indication: The patient currently has an intrathecal drug delivery pump in bad position, the pump has not been sutured down to the fascia so the pump has slipped and the pump is not usable and cannot be refilled. Description of Procedure: The area of the left lower quadrant of the abdomen was prepped and draped, surgical site was covered with ioban. An incision was made along the previous incision in the left lower corner of the abdomen which allowed exposrue of the intrathecal pump. the incision was carried down until the intrathecal pump was exposed and it was taken out of the pocket. Hemostasis was applied. then an incision was made about 1 1/2 inch anterior to the previous incision in the left lower quadrant of the abdomen. An appropriately sized pocket to implant the drug delivery pump was created using blunt dissection. Hemostasis was applied. the catheter was disconnected from the pump and it was passed to the new pocket. the catheter was reconnected to the pump. Aspiration was done through the side port of the pump. About 2.5 ml of CSF was aspirated. the pump was filled with preservative free morphine 10 mg per ml with 20 ml solution. Both pockets were irrigated with bacitracin solution. the pump implant was placed into the new pocket and was anchored down to the fascia using 5 ethibond sutures. both incisions were closed using 2.0 vicryl suture in the subcutaneous layer. the skin closure was done with staples. The surgeon describes the device as a pump and not a subcutaneous reservoir, the pump was sutured to fascia, so i did not feel CPT 62360 was correct. i get a device edit with CPT 62362 - the pump was not replaced with a new pump. 62350 appears to describe repositioning of the intrathecal portion of the device rather than the LLQ abdominal pump portion. Can you please advise? thank you. 62362
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