Patient-Controlled Analgesia - CAM 100107
Description:
Two types of patient-controlled analgesia are described as follows:
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Intravenous patient-controlled analgesia (IV-PCA): With IV-PCA, the patient pushes a button and self-administers low doses of intravenous narcotic medication via a pump for the relief of pain. This type of pain control is generally used for postoperative purposes, but can also be used for hospitalized patients with other types of severe pain, as well as in the management of pain due to chronic cancer.
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Patient-controlled epidural analgesia: With patient-controlled epidural analgesia, an epidural or intrathecal catheter is inserted, and local anesthetics or narcotics are used in conjunction with a pump to deliver small doses of the agent directly to the spinal nerves. Because of the low doses needed to obtain pain relief, side effects such as nausea, sedation and respiratory depression can be minimized. This type of pain control is used extensively in obstetrical procedures and for lower-body postoperative pain. It is also used in the pain management of terminal cancer patients and for chronic intractable pain of non-cancerous origin.
With both methods of pain control, the devices are programmed to limit the hourly dosage and intervals between doses to prevent overdosing.
Policy:
IV-PCA is MEDICALLY NECESSARY in the management of postoperative pain following major surgical procedures and for the medical management of chronic unresponsive cancer pain.
Patient-controlled epidural analgesia is MEDICALLY NECESSARY following obstetrical procedures and major surgical procedures involving the organs of the pelvis and lower extremities; for the medical management of chronic cancer pain; and for chronic intractable pain of non-cancerous origin.
Coding Section
Codes | Number | Description |
CPT | 01996 | Daily management of epidural (or subarachnoid) drug administration |
62350 | Implantation (revision or repositioning) of intrathecal or epidural catheter, for implantable reservoir or implantable infusion pump. without laminectomy | |
62360-62362 | Implantation (or replacement) or device for intrathecal or epidural drug infusion; subcutaneous reservoir | |
ICD-9 Procedure | 99.29 | Injection or infusion of other therapeutic or prophylactic substance |
ICD-9 Diagnosis | No Code | |
HCPCS | A4300 | Implantable access catheter (includes epidural), external access |
A4305-A4306 | Disposable drug delivery system (code range) | |
E0781-E0783 | Infusion pump (code range) | |
Type of Service | Medical/Surgery | |
Place of Service | Inpatient/Outpatient; Physician's Office |
Procedure and diagnosis codes on Medical Policy documents are included only as a general reference tool for each policy. They may not be all-inclusive.
This medical policy was developed through consideration of peer-reviewed medical literature generally recognized by the relevant medical community, U.S. FDA approval status, nationally accepted standards of medical practice and accepted standards of medical practice in this community, and other nonaffiliated technology evaluation centers, reference to federal regulations, other plan medical policies and accredited national guidelines.
"Current Procedural Terminology© American Medical Association. All Rights Reserved."
History From 2014 Forward
02/08/2024 | Annual review. No change to policy intent. |
02/09/2023 | Annual review. No change to policy intent. |
02/01/2022 |
Annual Review. No change to policy intent. |
02/02/2021 |
Annual Review. No change to policy intent. |
02/19/2020 |
Annual review. No change to policy intent |
02/01/2019 |
Annual review. No change to policy intent. |
02/28/2018 |
Annual review. No changes made to policy. |
02/08/2017 |
Annual review. No Changes made. |
02/03/2016 |
Annual review. No changes made. |
03/05/2015 |
Removed Disclaimer per mgmt. |
02/10/2015 |
Annual review, adding coding. Policy to remain active, but will not undergo scheduled review after 2015. |
08/28/2014 |
Changed category. |
02/3/2014 |
Annual review. No changes made. |