# continuous spinal



## TTcpc (Mar 22, 2010)

I am still fairly new to anesthesia and need some advice on this, my gut is telling me the advice that I got here at work is not right.  

74 y.o. with multiple high risk factors (severe heart disease/issues, kidney, and epilepsy difficulties) undergoes a IM nail to (L) hip.  Due to medical issues the patient is not sedated, but given a continuous epidural.  I have requested more info from the anesthesiologist as I cannot read the medication used in the epidural.

Am I correct in thinking since the patient was not sedated, that I would bill the correct CPT code for the continuous epidural (once I find out the medication used) and not the ASA code?  I was told to just use the ASA code since the epidural was the method of anesthesia, but my gut says not so. 
Any advice would be appreciated.


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## AuntJoyce (Mar 22, 2010)

*Continuous spinal...*

Hi,

We do these all the time and the proper coding would consist of 01230 as your ASA code.  You would assign your Physical Status Level which sounds like it would more than likely be 4.  Your type of anesthesia would be listed as Spinal.

Hope this helps.


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## hgolfos (Mar 22, 2010)

I agree with Aunt Joyce, since your anesthesia technique was spinal you would bill the ASA code base plus time.  I've been billing anesthesia for 9 years now, and we have these every day.


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## TTcpc (Mar 22, 2010)

Thank you both very much for the help.  This is the first of this kind that I have come across since I've been here.


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## hgolfos (Mar 22, 2010)

You're welcome!  ;-)  Even after nine years I still learn new things every day.  It's an adventure!


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## AuntJoyce (Mar 22, 2010)

*Continuous spinal...*

You are very welcome and hgolfos is right on the money - every day is a new adventure.  Just when you think you know it all, something new crops up.

Have a good one


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