Anesthesia Coding Alert

Question: Can I bill separately for a catheter placed by the medically directing anesthesiologist for a postoperative pain epidural prior to extubation? Is this a standard way to handle the procedure, or is the patient usually extubated before the catheter is placed?

Maine Subscriber  
Answer: If the catheter was placed prior to surgery but not used for the mode of anesthesia during the procedure, you can bill 62319 (injection, including catheter placement, continuous infusion or intermittent ...) and append with modifier -59 (distinct procedural service). If, however, the catheter was used for any part of the anesthesia during the procedure, you can only bill for follow-up days with it (01996, daily management of epidural or subarachnoid drug administration).
 
Note: The epidural catheter for post-op pain management cannot be placed while the anesthesiologist is billing time units. Most providers place the catheter prior to surgery and the official anesthesia start time.