Anesthesia Coding Alert

Check into daily management codes for follow-ups.

Thanks to a sharp-eyed subscriber who spotted an error in one of our reader questions in the January issue (ACA Vol. 13 N. A, page 6). Following is the original question with the corrected answer regarding codes 64448 and 01996.

Postop Catheter Coding Allowed When Separate

Question: Our provider used monitored anesthesia care (MAC) for the primary mode of anesthesia during a procedure. He also inserted a femoral nerve continuous catheter and documented that the catheter was for postoperative pain relief. Can we bill separately for the continuous catheter? Florida Subscriber

Answer: Yes, you can report the continuous catheter under one stipulation. Your provider must adequately document that the continuous catheter would be used for postoperative management and was not used for the mode of anesthesia during the procedure.

Report the catheter placement with 64448 (Injection, anesthetic agent; femoral nerve, continuous infusion by catheter [including catheter placement]). The time spent on placement of the block is not reported with anesthesia time, although you do not need to deduct time if the post surgical block occurs after induction and prior to emergence. Append modifier 59 (Distinct procedural service) to emphasize the catheter's separate use.

Follow up: If you're able to code for the catheter placement, you can also report additional days if your physician provides follow up care during the postoperative period. Do not report 01996 (Daily hospital management of epidural or subarachnoid continuous drug administration) as this code represents daily hospital management of an epidural or subarachnoid catheter. You may report subsequent hospital care codes (99231-99233), depending on the documentation provided, for each day of necessary follow up care.