Summary & Overview
CPT 62351: Implant/Revision of Intrathecal or Epidural Catheter
CPT code 62351 represents surgical implantation, replacement, or repositioning of a previously tunneled intrathecal or epidural catheter, including a laminectomy, to permit medication delivery into the cerebrospinal fluid via an external or internal reservoir pump. This code covers procedures used for severe acute or chronic pain (including cancer-related pain and postoperative pain) and for conditions such as spasticity that require targeted neuraxial drug delivery. Nationally, this code is relevant to hospitals, neurosurgery and pain management practices, and payers due to the procedural complexity, facility resources required, and implications for bundled payment and utilization oversight.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context about the intended use of the procedure, typical sites of service, and what this service line entails. The publication also provides benchmarks and policy context where available, including payer coverage patterns, common billing modifiers and coding considerations, and related procedural coding for neuraxial drug-delivery systems. Data gaps are identified when input was not provided. The material is intended for coding professionals, revenue cycle managers, and clinical leaders who require a concise technical overview of CPT code 62351 and its role in neuraxial drug delivery services.
Billing Code Overview
CPT code 62351 describes the implantation, replacement, or repositioning of a previously implanted and tunneled intrathecal or epidural catheter. The procedure includes a laminectomy and is performed to enable instillation of medication into the cerebrospinal fluid via an external or internal reservoir pump system.
Service Type
- Surgical implant/revision of intrathecal or epidural catheter
Typical Site of Service
- Hospital operating room or inpatient surgical setting, often performed where a laminectomy and neuraxial catheter work can be performed safely under anesthesia
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient with refractory cancer-related pain previously managed with an implanted intrathecal drug-delivery catheter presents with malfunction and persistent uncontrolled pain after device interrogation. The pain management team evaluates the patient in preoperative clinic, confirms catheter dysfunction with imaging and trial bolus failure, and schedules operative revision. In the operating room under general anesthesia, the surgeon exposes the previous catheter tract, removes the dysfunctional tunneled intrathecal catheter and reservoir pump components as needed, performs a laminectomy to access the intrathecal space, and implants and tunnels a new intrathecal catheter connected to an external or internal reservoir/pump system. Intraoperative neuro-monitoring and fluoroscopy guide catheter tip placement. Postoperative care includes pain control, wound care, neurologic assessments, and programming/verification of the pump reservoir. Discharge planning includes opioid-sparing intrathecal medication titration and outpatient pump programming follow-up with the implanting pain specialist or neurosurgeon.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | (Not standard CMS modifier) | Data not available for CMS definition; use payer-specific guidance. |
11 |