Summary & Overview
HCPCS C1755: Catheter, Intraspinal
HCPCS Level II code C1755 identifies an intraspinal catheter, an implantable device used to deliver medications directly into the spinal canal for pain control or management of spasticity. Nationally, this code matters because it governs payment and documentation for a high-cost, device-driven intervention that intersects surgical, anesthesiology, and pain-management services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for intraspinal catheter use, typical sites of service, and the administrative considerations associated with billing this HCPCS Level II code. The publication summarizes payer coverage patterns, common modifiers seen with device and procedural billing, and benchmarks for reimbursement where available.
The report also provides guidance on coding context: how C1755 fits into device and supply reporting for interventional pain procedures, documentation expectations tied to device implantation and management, and common billing scenarios encountered in hospitals and ambulatory surgical centers. Data not available in the input are noted where applicable.
Billing Code Overview
HCPCS Level II code C1755 describes a catheter, intraspinal. This device is used to deliver medications directly into the intraspinal space for therapeutic management of pain or spasticity.
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Service type: Implantable medical device / interventional pain management supply
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Typical site of service: Hospital inpatient, hospital outpatient, ambulatory surgery center, or specialized pain management clinic
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with chronic, severe cancer pain or refractory spasticity who requires long-term intrathecal therapy for analgesia or muscle relaxant delivery. The patient often has failed multiple systemic analgesics or oral antispasmodics and is referred by pain management or neurology for an intrathecal catheter placement as part of an implanted pump system. The workflow begins with pre-procedure evaluation in an outpatient pain clinic or specialty clinic where history, prior treatments, coagulation status, and infection risk are assessed. Imaging such as fluoroscopy or ultrasound is reviewed to plan catheter entry level (commonly lumbar). On the day of service, the patient presents to an ambulatory surgery center or hospital operating room; the procedure is performed under monitored anesthesia care or general anesthesia. Under sterile technique and fluoroscopic guidance, the physician advances an intrathecal catheter into the subarachnoid space and secures it for connection to an implanted infusion pump or externalized for trial infusion. Post-procedure, the patient is monitored in PACU for neurologic exam, hemodynamics, and signs of CSF leak or infection before discharge to home or inpatient bed with wound and pump-care instructions and outpatient follow-up for programming and medication titration.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required is substantially greater than typical for catheter placement (eg, extensive dissection, unusual anatomy). |