Anesthesia Coding Alert

Plus: Prepare for changes to 77003, too.

Although you won't report new or revised CPT codes until January 2012, prepare yourself -- and your anesthesia providers -- now for revisions that can affect your everyday coding, such as the rewording of two popular epidural codes.

Examine the Descriptor Differences

The primary changes apply to epidural codes CPT 62310 and 62318. The current and upcoming descriptors are as follows:

The new descriptors incorporate several changes:

• 62310 clarifies that it can be used for more than one single injection.
• 62310 no longer mentions the possible use for epidurography. "Epidurography is a separate procedure that doesn't need to be related to this code," explains coding consultant Samantha Fowler, CPC, CPC-I, MCS-P, ACS-AN.
• The current version of 62310 doesn't include catheter administration, but the revised descriptor does. "Physicians were placing catheters for single shots and trying to bill 62310 or 62311," Fowler explains. "The difference is that one pair of codes is for continuous or intermittent bolus (62318/62319) and the other is for a single dose at a time (62310/62311), irregardless of catheter use."
• The revised 62318 specifies "indwelling" catheter and changes from "injection" to "injections".

Also note: Codes 62311 and 62319 now read "lumbar or sacral (caudal)" instead of "lumbar; sacral (caudal)."

Don't Miss Fluoro and Nerve Destruction Changes

If you sometimes report 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, subarachnoid, or sacroiliac joint], including neurolytic agent destruction) in conjunction with diagnostic or therapeutic injections, be sure to note the descriptor change, come January.

The new descriptor will read "Fluoroscopic guidance and localization or needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid)."

Change: The code no longer includes guidance for sacroiliac joint injections or neurolytic agent destruction.

Replacements: Codes 64622-64627 for paravertebral facet joint nerve destruction have been deleted and replaced with four new codes:

• 64633 -- Destruction by neurolytic agent, paravertebral facet joint nerve(s) with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint
• 64634 -- ... cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure)
• 64635 -- ... lumbar or sacral, single facet joint
• 64636 -- ... lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure).

Watch for more details about these changes and how they might affect your coding in future issues of Anesthesia Coding Alert.