Summary & Overview

CPT 62350: Intrathecal/Epidural Catheter Implant or Revision

CPT code 62350 covers implantation, replacement, or repositioning of a previously tunneled intrathecal or epidural catheter used with an external or internal reservoir pump to deliver medication into the cerebrospinal fluid. This procedure enables targeted drug delivery for severe pain management, cancer-related pain, postoperative pain, spasticity, and other conditions requiring intrathecal therapy. Nationally, the code is important because it supports access to specialized neurosurgical and pain-management services that can reduce systemic opioid exposure and improve symptom control for complex patients.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing framing of the service, payer coverage context, and what to expect in terms of typical sites of service and service type. The publication outlines benchmarks and policy considerations relevant to reimbursement and prior authorization practices, summarizes typical clinical indications, and highlights coding boundaries (for example, exclusion of laminectomy in the procedure). Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 62350intrathecal catheterepidural catheterspinal drug deliverypain managementimplant revisionneurosurgeryambulatory surgeryhospital outpatientprocedure coding

Billing Code Overview

CPT code 62350 describes the implantation, replacement, or repositioning of a previously implanted and tunneled intrathecal or epidural catheter. The procedure excludes a laminectomy and is performed to enable instillation of medication into the cerebrospinal fluid using an external or internal reservoir pump system.

Service type: Surgical implant/revision of tunneled intrathecal or epidural catheter to facilitate drug delivery into the cerebrospinal fluid
Typical site of service: Operating room or interventional suite, often in a hospital inpatient or outpatient setting, or ambulatory surgery center

Clinical & Coding Specifications

Clinical Context

A 54-year-old patient with chronic, refractory cancer-related back pain managed previously with an implanted intrathecal catheter presents with malfunction of the tunneled catheter and inadequate analgesic delivery. The patient reports increased pain scores, decreased sensation in the lower extremities is absent, and reservoir pump interrogation suggests poor flow. The neurosurgery or pain management team schedules the patient for an operative procedure to replace or reposition the previously implanted tunneled intrathecal catheter to restore intrathecal drug delivery.

The clinical workflow includes preoperative evaluation (medical history, medication reconciliation, neurological exam, and imaging review), perioperative antibiotic prophylaxis and informed consent, placement in the operating room or ambulatory surgery center, device interrogation and localization, administration of anesthesia (general, monitored anesthesia care, or regional as indicated), surgical exposure of the previous catheter site, removal and replacement or repositioning of the tunneled intrathecal or epidural catheter without performing a laminectomy, securement and tunneling of the new catheter, intraoperative confirmation of catheter patency with cerebrospinal fluid aspiration or contrast under fluoroscopy, pump/catheter connection as needed, wound closure, postoperative recovery, device programming and medication titration, and discharge with follow-up for wound check and pump refilling as needed.

Typical site of service: hospital operating room or ambulatory surgery center.

Typical service type: operative procedure for intrathecal/epidural catheter management (implantation, replacement, or repositioning) intended for delivery of medication into cerebrospinal fluid for severe pain or spasticity management.

Coding Specifications

Modifier	Description

Taxonomy Code	Specialty	Notes
2084P0800X	Pain Medicine	Specialists who manage intrathecal pump systems and catheter revisions.
2086S0122X	Neurological Surgery	Neurosurgeons perform catheter implantation, replacement, or repositioning.
363LP0800X	Anesthesiology (Pain Management)	Anesthesiologists with pain subspecialty perform these procedures and perioperative management.
207RH0000X	Physical Medicine & Rehabilitation	PM&R physicians may manage spasticity and coordinate intrathecal therapy.
207L00000X	Surgery (General)	General surgeons seldom perform but may be involved in select cases.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`62350`	Implantation, replacement, or repositioning of previously implanted and tunneled intrathecal or epidural catheter; does not include laminectomy	Primary procedure described; used when replacing or repositioning a tunneled intrathecal/epidural catheter for medication delivery.
`63650`	Percutaneous implantation of neurostimulator electrode array; and pulse generator placement when performed, including connection	May be performed in pain workflows for neuromodulation as an alternative or adjunct to intrathecal therapy; separate procedure when neuromodulation is indicated.
`63550`	Identification, reprogramming, or replacement of implanted neurostimulator pulse generator or receiver	Related to device management when external or internal pump systems require programming or replacement in the same episode of care.
`62360`	Failure or revision of tunneled catheter featuring pump interface (note: actual code for intrathecal pump revision is `62362` for insertion of catheter attached to pump)	Related catheter revision codes may be used when other catheter or pump components require separate reporting.
`99152`	Moderate sedation services provided by the same physician performing the procedure, initial 30 minutes	Often reported when monitored anesthesia care or moderate sedation is provided during catheter procedures (verify payer rules).

Note: If specific adjunct or pump insertion codes are needed, coders should select the code that accurately reflects the distinct services performed and follow payer-specific bundling rules.

`11`	Normal or routine service	Use when the procedure is performed as planned without complications.
`22`	Increased procedural services	Use when the procedure requires substantially greater effort or time than typical (extensive scar tissue, complex tunneling).
`52`	Reduced services	Use when the service is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when procedure is terminated due to extenuating circumstances prior to completion.
`59`	Distinct procedural service	Use to indicate a distinct procedural service when another procedure on a separate anatomic site or distinct session occurred.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct operative components.
`63`	Procedure performed on infants less than 4 kg	Rarely applicable; use in neonatal cases meeting weight criteria.
`78`	Unplanned return to the operating room for a related procedure during the postoperative period	Use if the patient returns to OR for complications related to the initial catheter procedure.
`79`	(Not in provided list)	Data not available in the input.
`LT`	Left side	Use for laterality when documentation specifies left-sided approach.
`RT`	(Not in provided list)	Data not available in the input.
`58`	Staged or related procedure or service by same physician during postoperative period	Use when a planned staged catheter revision is performed during the global period.
`73`	Discontinued outpatient procedure before anesthesia administered	Use if the outpatient procedure is cancelled before anesthesia and no operative work performed.

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