Morphine may be administered by the intravenous, intramuscular, subcutaneous, epidural or intrathecal routes of administration. It is used for the management of severe pain which may occur post-surgically, after severe trauma, or during the progression of a pathological disease process (e.g., cancer).
Access of the route of drug administration may be gained by direct conventional transepidermal injection techniques in the appropriate area, injection through an external catheter port, or by injection through a previously implanted port/reservoir catheter site. Morphine may be administered by intermittent injection (discreet intervals) or by continuous infusion when diluted in compatible solutions.
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary.
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.
CODE REFERENCE This may not be a comprehensive list of procedure codes applicable to this policy. The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document.
|62310||Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; cervical or thoracic |
|62311 ||lumbar, sacral (caudal) |
|62318 ||Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; cervical or thoracic|
|62319 ||lumbar, sacral (caudal)|
|62350||Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy |
|62351||Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminectomy |
|62355||Removal of previously implanted intrathecal or epidural catheter|
|62360 ||Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir |
|62362||Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming|
|62365||Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion |
|62367||Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming |
|62368 ||Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming|
|95990||Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular)|
Note: The refill and maintenance of an intraventricular pump or reservoir is not covered.
|99551||Home infusion for pain management (intravenous or subcutaneous), per visit |
|99552 ||Home infusion for pain management (epidural or intrathecal), per visit |
|03.90 ||Insertion of catheter into spinal canal for infusion of therapeutic or palliative substances |
|03.92 ||Injection of other agent into spinal canal |
|86.06 ||Insertion of totally implantable infusion pump |
Injection or infusion of other therapeutic or prophylactic substance
Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access
|A4301 ||Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.) |
|E0779 ||Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater |
|E0780 ||Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours |
|E0781||Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
|E0785 ||Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement |
|E0786 ||Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter) |
|J2270 ||Injection, morphine sulfate, up to 10 mg |
|J2271 ||Injection, morphine sulfate, 100 mg (Deleted 12-31-2014)|
|J2275||Injection, morphine sulfate (preservative-free sterile solution), per 10 mg (Deleted 12-31-2014)|
|S0093||Injection, morphine sulfate, 500 mg (loading dose for infusion pump) |
This may not be a comprehensive list of procedure codes applicable to this policy.
|61026 ||Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment |
|61215 ||Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter |
|01.02 ||Ventriculopuncture through previously implanted catheter |