You have had a successful trial of targeted drug delivery and have decided to pursue the permanent implantation.
What happens next?
Intrathecal pump implantation is a surgery which requires special authorization. Our clinic works with a third party called Medtronic Reimbursement Department to ensure that this surgery will be covered by your insurance. Once you have completed a successful trial, our clinic will send the necessary records to the reimbursement department. The reimbursement department will contact your insurance company or refer to the coverage policies in order to reach a decision on coverage. Our clinic requires an approval from the reimbursement department before we can schedule the surgery. Keep in mind, even though they have approved the pump implant, there still may be out of pocket expenses that you will be responsible for
** It may take 4-6 weeks to get this approval. **
Pre-operative History and Physical Evaluation
Once we receive approval from your insurance company, you will be contacted by our clinic. You will need to obtain a pre-operative history and physical evaluation. This is an examination to evaluate your health status and â€œclearâ€ you for surgery. This can be done at TCPC, or your primary care provider if you prefer. Do not schedule this until you have been contacted by our clinic about the approval. Please have this evaluation faxed to 952-841-2346.
A scheduling coordinator will be in touch with you after we receive the approval from your insurance company. They will remind you to schedule your pre-op physical, mail you a packet of information and go over all of the necessary appointments. Be prepared to schedule the following appointments:
- Med Check Appointment: If you are in need of a medication refill you will need to be seen by your provider prior to the pain pump implant.
- Pump Implant Education Appointment: We will review the procedure in detail. Please bring in the signed pump consent form that you received in the mail. This appointment is done at TCPC with your provider. No medications are refilled at this appointment and it cannot be combined with your med check appointment.
- Intrathecal Pump Implantation: The implant surgery is performed at either Twin Cities Surgery Center or Fairview Southdale Hospital, depending on your insurance coverage.
- Wound Check: 2-3 days after surgery.
- Follow Up Appointment: You will meet with your primary TCPC provider 2 weeks after the surgery.
Pain Pump Implantation
An intrathecal pump implantation is a surgery involving placing a catheter within the epidural space and then connecting it to an internal pump. The surgery is performed at Twin Cities Surgery Cneter or Fairview Southdale Hospital, depending on your insurance coverage.
- You will receive general anesthesia during the surgery and will need a driver. Do not have anything to eat or drink for 8 hours prior to the procedure.
- The Surgery is outpatient and you should plan on being there for 3-5 hours.
You will continue taking your regular pain medication, as instructed by your provider.
- You will receive an antibiotic to prevent infection. Let your TCPC provider know if you have any allergies to antibiotics. Start this the day after the surgery and take it for 10 days.
- There are certain activities that should be avoided for 6-8 weeks after surgery to prevent movement of the pain pump catheter, including bending at the waist, twisting, reaching overhead, and lifting more than 5 pounds.
- Do not shower, bathe, or get the incisions wet until you are cleared to shower at your nurse visit (3-4 days post op). Then showers only until you are cleared by your provider to bathe/soak/swim (2-3 weeks post op).
- Notify the clinic for: excessive sleepiness, headache that lasts longer than 2 days, signs of an infection, changes in your bowel or bladder function, or weakness of the legs.
If you have additional questions regarding the Pump Implant, or other treatment options please call Twin Cities Pain Clinic 952-841-2345.