Summary & Overview
CPT 62367: Implantable Pump Performance Analysis, No Reprogramming
CPT code 62367 represents a clinical service in which a provider evaluates the performance of an implantable intrathecal or epidural pump without performing reprogramming or medication refill. The code captures a focused device assessment procedure that supports ongoing management of patients receiving targeted intrathecal or epidural therapy for pain control or regional chemotherapy delivery. Nationally, accurate coding of device interrogation encounters affects clinical documentation, care coordination, and payer adjudication for high-cost implantable drug-delivery systems.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context and typical sites of service, along with benchmarks and policy considerations relevant to coverage and billing for device performance analysis. The publication outlines common documentation elements that support appropriate use of CPT code 62367, highlights where payer policies commonly intersect with clinical practice, and summarizes relevant coding relationships and related services.
This summary is intended for a national audience of clinicians, coding professionals, and policy analysts who need a clear description of the service captured by CPT code 62367, the payers commonly involved, and the types of information that drive coverage and payment decisions. Data not available in the input is identified as such in the detailed sections.
Billing Code Overview
CPT code 62367 describes an encounter in which a provider analyzes the performance of an implantable pump without reprogramming or refilling the device. These pumps — intrathecal or epidural — are typically used to deliver pain medications or chemotherapy for patients with chronic pain, malignancy-related pain, or other conditions requiring targeted drug delivery.
Service Type: Device performance analysis / Evaluation of implantable pump function
Typical Site of Service: Outpatient clinic or ambulatory surgical center (procedures performed during a clinic visit or procedural suite where pump interrogation and assessment occur)
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with chronic, refractory cancer-related pain managed by an implanted intrathecal pump presents for a routine ambulatory device check. The patient denies new neurologic deficits or infection signs but reports intermittent increases in pain requiring assessment of pump performance. The clinician reviews the device telemetry, evaluates reservoir and catheter integrity indirectly (pump diagnostics, interrogation of reservoir pressure and flow data), documents pump status, and determines that no reprogramming or medication refill is required. The visit occurs in an outpatient clinic or ambulatory surgery center where device interrogation equipment and trained pain or neurosurgery staff are available. Typical workflow: pre-visit medication and symptom review, interrogation of the implantable pump with manufacturer-specific programmer, documentation of pump performance and alarms, counseling the patient about device function and follow-up, and scheduling refill or reprogramming visits if indicated. The service reported is monitoring/analysis only and does not include pump reprogramming or intrathecal medication refill.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the clinician's professional service separate from facility technical component, if applicable. |
52 |