Get Paid for Post-procedure Pain Management
Published on Sun Oct 01, 2000
Many patients who undergo serious surgical procedures like total knee replacement (27447, arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing) or shoulder resection (23077, radical resection of tumor [e.g., malignant neoplasm], soft tissue of shoulder area) often require additional pain management medication for several days following the process. Others need relief from chronic pain. Whether this is in the form of epidural or subarachnoid injections or a femoral or interscalene block, reimbursement is possible, in addition to the original procedures anesthesia. By working with local carriers and ensuring that documentation supports the diagnosis codes considered medically necessary for the service, anesthesia providers can reap the rewards of providing continuous pain management care.
Clearly Document Separate Purposes
One of the most important facts to document in the patients record is that the post-op anesthesia is completely separate from the procedural anesthesia. Epidural and subarachnoid injections usually are coded using 62310 (injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; cervical or thoracic) or 62311 (injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; lumbar, sacral [caudal]).
Injections including catheter placement usually are coded using 62318 (injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; cervical or thoracic) or 62319 (injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, anti-spasmodic, opioid, steroid, other solution], epidural or subarachnoid; lumbar, sacral [caudal]).
Depending on the situation and the documentation in the patients chart, these codes may not be eligible for use as separate pain management codes following a procedure. Consider these examples:
A catheter may be the mode of anesthesia for the surgery and then used postoperatively for pain management. In this situation, you should bill the applicable anesthesia code for the procedure like 27447 (total knee replacement) on the day of surgery and bill 01996 (daily management of epidural or subarachnoid drug administration) for the following days.
The surgeon and/or anesthesiologist may decide up front that the patients postoperative pain will be significant enough to require a higher level of pain management. If so, a catheter may be placed preoperatively with the intent of using [...]
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