Summary & Overview
CPT 62365: Explantation of Intrathecal or Epidural Infusion Pump/Reservoir
CPT code 62365 covers the surgical removal of a previously implanted subcutaneous reservoir or pump used for intrathecal or epidural medication infusion. This procedure is performed when the device is no longer needed or when complications such as infection necessitate explantation. Nationally, explantation of implanted intrathecal or epidural delivery systems is clinically significant because these devices are central to long-term pain management and spasticity control; removal procedures affect inpatient and ambulatory surgical workflows, device management policies, and payer coverage decisions.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise clinical context about the service type and typical sites of care, plus an overview of what to expect in claims and coding for device explantation. The publication summarizes benchmarks and policy-relevant considerations for coverage and reimbursement, highlights common procedural settings, and identifies areas where payer guidance or preauthorization practices commonly apply. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 62365 describes the removal of a previously implanted subcutaneous reservoir or pump that was used for intrathecal or epidural infusion of medication. The procedure involves explanting a reservoir or infusion pump that has been placed under the skin for direct delivery of medication to the spinal canal.
Service type: Surgical removal/explantation of implanted infusion device
Typical site of service: Hospital operating room or ambulatory surgical center, with the implant located in a subcutaneous pocket (e.g., abdominal or flank area)
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 56-year-old patient with a history of chronic spasticity managed with an implanted intrathecal drug delivery pump presents with erythema, drainage, and tenderness over the subcutaneous pump pocket. The implanted reservoir/pump was originally placed for long-term intrathecal baclofen infusion. On examination and imaging, there is concern for pocket infection and possible device contamination. The clinical workflow includes preoperative evaluation (labs, wound culture, imaging if indicated), discontinuation or diversion of intrathecal therapy, informed consent, and scheduling for operative removal of the subcutaneous implant. In the operating room under monitored anesthesia care or general anesthesia, the surgeon explants the implanted reservoir/pump (62365), inspects and cultures the pocket, irrigates, and achieves hemostasis. Postoperative care includes pain control, wound care instructions, antibiotic therapy guided by culture results, and coordination of alternative spasticity management if needed. Typical site of service is an ambulatory surgery center or hospital operating room. The service is performed when infection, device malfunction, or cessation of need requires complete removal of the implanted reservoir or pump.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier applicable (placeholder) | Rarely used; included in payer lists but generally not appended clinically |