Summary & Overview
HCPCS C2626: Implantable Temporary Non-Programmable Infusion Pump
HCPCS Level II code C2626 designates a temporary, implantable, non-programmable infusion pump used to deliver medications directly to a target site. This device-based code matters nationally because it governs billing for an advanced delivery system that can affect procedure coding, facility charges, and durable medical equipment categorization for short-term implantable infusion therapy. Key payers addressed 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 role, typical settings, and the payer landscape relevant to coverage and billing. The publication summarizes reimbursement benchmarks and coding practice considerations, highlights common billing modifiers and service-line implications, and situates the device within clinical workflows for implantation and removal. It also notes where input data is unavailable, such as associated taxonomies or ICD-10 diagnoses, and points readers to sections that cover related codes and policy updates affecting device reimbursement and facility billing practices.
Billing Code Overview
HCPCS Level II code C2626 describes an infusion pump, non-programmable, temporary (implantable). This device is a temporary, implantable infusion pump intended to deliver therapeutic agents directly into a body site for a limited duration. The service type is implantable infusion device therapy. The typical site of service is an inpatient or outpatient surgical setting where implantation and removal procedures are performed, including operating rooms and ambulatory surgical centers.
Service details and clinical use cases are not provided in the input. Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient with chronic, refractory pain related to metastatic cancer is evaluated by a pain management specialist for continuous intrathecal analgesia. After multidisciplinary review, an implantable, temporary infusion pump is selected for short-term targeted opioid delivery to decrease systemic side effects. The procedural workflow includes preoperative evaluation and consent, device selection and testing, sterile implantation of the non-programmable temporary implantable infusion pump in the subcutaneous pocket with catheter tunneled to the intrathecal space, intraoperative verification of catheter placement and pump function, postoperative monitoring for hemodynamic stability and neurologic status, programming confirmation (if applicable for refill or initial rate), and discharge planning with outpatient pump management and scheduled follow-up for refill or removal.
Key personnel involved include an interventional pain physician or neurosurgeon, an anesthesiologist for sedation or monitored anesthesia care, operating room nursing, and device representative support. Typical indications include refractory cancer pain, severe spasticity requiring intrathecal baclofen trial then temporary pump placement, or short-term analgesic needs where a temporary implantable pump provides targeted therapy while longer-term decisions are made. The typical site of service is an operating room or procedure suite within an acute care hospital or ambulatory surgery center equipped for sterile implant procedures and postoperative observation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |