Epidural, Intrathecal, and Intraventricular Morphine Administration
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.
Epidural or intrathecal morphine administration for the management of severe, intractable pain is considered eligible for coverage.
Intraventricular administration of morphine is considered investigational.
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.
9/1994: Approved by Medical Policy Advisory Committee (MPAC)
2/14/2002: Investigational definition added, Managed Care Requirements deleted, Prior Authorization put under the Policy Section
3/5/2002: Prior authorization deleted
4/26/2002: Type of Service and Place of Service deleted
11/12/2003: Code Reference section updated, CPT code range 62274-62279 deleted
08/28/2015: Code Reference section updated for ICD-10. Removed ICD-9 procedure code 99.29 from the Code Reference section.
Uniform Medical Policy Manual (11/1989)
CODE REFERENCEThis 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.
Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment
Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter
Ventriculopuncture through previously implanted catheter
Collection of cerebrospinal fluid from indwelling device in nervous system