tci E/M Coding Alert - 2024 Issue Q2

Reader Questions: Check Whether QHP Performed Pump Refill

Question: If a patient has an implantable pump in their spine that the provider refills for drug delivery, can you report this service separately? Or is it part of the overall evaluation and management (E/M) service? Massachusetts Subscriber Answer: If there is no record of a physician or other qualified healthcare professional (QHP) present during the refill, report 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). If a physician or other QHP performs the refill, you can report 95991 (Refilling and maintenance...

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