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Insertion of On-Q or PainBuster Catheter or Device – Not Covered by Upstate Medicare Division (GEN)
Posted January 17, 2007
This article was published to address claims received for physician insertion of On-Q catheters or PainBuster catheters or associated devices designated for postoperative pain management.
These catheters or devices are inserted in the operative site after the surgeon’s completion of the surgical procedure and are left in place for the purpose of delivery of periodic doses of local anesthetic via a small delivery device.
The Medicare Claims Processing Manual (Pub. 100-04), Chapter 12, §40 – Surgeons and Global Surgery states, “…insertion, irrigation, and removal of drains, catheters, lines, tubes is a component of the global surgical package.” Section 50 – Payment for Anesthesiology Services states, “Carriers may not allow separate payment for the anesthesia service performed by the physician who also furnishes the medical or surgical service.”
The Upstate Medicare Division (UMD) does not allow separate reimbursement for physician insertion of such catheters and devices. |
