Anesthesia Coding Alert

Question: What code would you use for the placement of a continual catheter in the brachial plexus for continuous infusion of local anesthetic for post-op pain management, followed by daily visits?

Arizona Subscriber

Answer: Code the block for the day the catheter was placed with 64415* (injection, anesthetic agent; brachial plexus) along with modifier -22 (unusual procedural services) and notes to support the blocks use. Bill the following days with code 99231 (subsequent hospital care, per day, for the evaluation and management of a patient) because the catheter is already in place. I assume the block is continuous; other codes would apply if it is patient-controlled analgesia. Although some people may want to use code 01996 (daily management of epidural or subarachnoid drug administration) for follow-up days, many experts caution against doing so for this type of situation because its definition specifies that it is for epidural or subarachnoid injections.