Summary & Overview
HCPCS Level II C1772: Infusion Pump, Programmable (Implantable)
HCPCS Level II code C1772 represents an implantable, programmable infusion pump used to deliver medications directly to a targeted body space. Implantable infusion pumps are used in chronic pain management, spasticity treatment, and other indications requiring continuous or programmable drug delivery; the code captures the device component of that therapy. Nationally, accurate coding for implantable infusion pumps affects device coverage, durable medical equipment oversight, and hospital outpatient billing.
Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, common service sites, and typical billing considerations tied to this device. The publication summarizes payer coverage patterns and benchmarks where available, notes relevant policy elements affecting device reimbursement, and outlines typical clinical scenarios in which C1772 is reported. Practical insights include device classification, typical utilization settings, and what to expect in payer program materials. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code C1772 describes an infusion pump, programmable (implantable). This device is an implantable, programmable infusion pump designed to deliver medications directly into a targeted body space over a prolonged period. The service type is durable medical device implantation and management involving the supply and implantation of a programmable infusion pump. The typical site of service is hospital-based operating rooms or ambulatory surgery centers for the implantation procedure, with ongoing device management and refills provided in outpatient specialty clinics or hospital outpatient departments.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with chronic, refractory cancer pain managed by an implanted programmable infusion pump presents for device implantation and programming. The workflow includes preoperative evaluation by a pain management specialist or neurosurgeon, informed consent including risks/benefits, perioperative anesthesia evaluation, implantation of the programmable intrathecal infusion pump percutaneously or via small incision in an operating room or ambulatory surgical center, connection of the pump to an intrathecal catheter positioned under fluoroscopy, initial programming of infusion parameters, intraoperative device interrogation and leak check, postoperative recovery with monitoring for respiratory depression or neurologic changes, discharge instructions for pump care and refill scheduling, and outpatient follow-up for titration and refills. Typical site of service is an operating room in an inpatient or outpatient surgical setting or an ambulatory surgical center. The service type is implantation of an implantable programmable infusion pump for chronic medication delivery (infusion therapy).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
AS | Ambulatory Surgical Center (ASC) facility service | Use when the implantation occurs in an ASC and the claim requires ASC facility designation |
62 |