Summary & Overview
CPT 62361: Implantation or Replacement of Nonprogrammable Intrathecal/Epidural Pump
CPT code 62361 covers implantation or replacement of a nonprogrammable subcutaneous pump used for continuous intrathecal or epidural infusion of medications. This procedure is clinically significant for management of refractory chronic pain, spasticity, and for targeted delivery of chemotherapeutic agents, offering an alternative route that can reduce systemic side effects and improve symptom control. Nationally, these implant procedures intersect with surgical, pain-management, and oncology care pathways and are subject to payer coverage policies and site-of-service considerations.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The report outlines typical clinical indications, procedural and site-of-service context, and what to expect from payer coverage patterns. Readers will find benchmarks for utilization and reimbursement context where available, summaries of relevant policy trends affecting access and prior authorization, and practical clinical context about device purpose and common applications. Data limitations are noted where input lacked specifics.
This summary is intended for clinicians, coding and billing professionals, and policy analysts seeking a concise national overview of CPT code 62361, its clinical role, and the payer landscape that influences access to implantable intrathecal/epidural pump therapy.
Billing Code Overview
CPT code 62361 describes the implantation or replacement of a nonprogrammable pump placed subcutaneously for intrathecal or epidural infusion of medication. The device enables continuous infusion of drugs such as anesthetics, antispasmodics, opioids, steroids, and other solutions for management of chronic pain and for administration of intrathecal or epidural chemotherapy.
Service Type: Implantation or replacement of implantable drug delivery pump for intrathecal/epidural infusion
Typical Site of Service: Inpatient hospital operating room or outpatient ambulatory surgery center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with chronic refractory cancer-related pain has failed multiple systemic and regional therapies and is referred for implantation of an intrathecal drug delivery pump for continuous opioid and adjunct medication infusion. Preoperative evaluation includes pain clinic assessment, informed consent, baseline neurologic exam, coagulation assessment, and optimization of comorbidities. On the day of service the patient undergoes general anesthesia or monitored anesthesia care in an operating room or ambulatory surgery center. The surgeon creates a subcutaneous pocket, tunnels a catheter to the intrathecal or epidural space under fluoroscopic guidance, positions and anchors the catheter, connects the catheter to a nonprogrammable pump reservoir, and implants the pump in the subcutaneous pocket. Intraoperative fluoroscopy and device function checks confirm placement. The procedure may require device programming verification, sterile dressing application, and postoperative observation with pain management education prior to discharge to home or inpatient admission if complications or medical comorbidities require monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Not a standard HCPCS/CPT modifier in CMS lists (present in raw list) | Data not available in the input. |
11 |