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Outpatient Hospital & Ambulatory Surgical Center Code Changes

8/6/2012
The Bureau for Medical Services Office of Facility Based and Residential Care is revising the following CPT (procedure codes) reimbursement methodology.

The codes below will no longer be reimbursed after 11/01/2012 in any outpatient facility setting.

Please remove the following CPT Codes from Outpatient Hospital and Ambulatory Surgical Center contracts:

62367
Electronic Analysis of Programmable Implanted Pump for intrathecal or epidural drug infusion (includes the evaluation of reservoir status, alarm status, and drug prescription status), without reprogramming or refill;
DO NOT USE: CPT Code 62367 in conjunction with 62368, 62369 or 62370.

62368
Electronic Analysis of Programmable Implanted Pump for intrathecal or epidural drug infusion (includes the evaluation of reservoir status, alarm status, and drug prescription status), with reprogramming;
DO NOT USE: CPT Code 62368 in conjunction with 62367, 62369 or 62370.

62369
Electronic Analysis of Programmable Implanted Pump for intrathecal or epidural drug infusion (includes the evaluation of reservoir status, alarm status, and drug prescription status), without reprogramming and refill;
DO NOT USE: CPT Code 62368 in conjunction with 62367, 62369 or 62370.

62370
Electronic Analysis of Programmable Implanted Pump for intrathecal or epidural drug infusion (includes the evaluation of reservoir status, alarm status, and drug prescription status); with reprogramming and refill requiring physician’s skill.
DO NOT USE: CPT Code 62370 in conjunction with 62367, 62368 or 62369.
 
In summary, this affects Outpatient Surgery in a hospital setting—as the aforementioned CPT Codes can no longer be billed in any outpatient setting. These codes do not require prior authorization.
 
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