Anesthesia Coding Alert

Question: How do I code an epidural blood patch procedure on the same day as labor and delivery? Should I include a modifier on the claim?

Minnesota Subscriber

Answer: Administering a blood patch on the same day as labor and delivery is unusual because most physicians try to manage spinal headaches conservatively before turning to an invasive treatment. Double check a few things before coding the blood patch procedure:

• Ensure that what you call a blood patch wasn’t simply injecting blood through the epidural catheter before removing it after labor and delivery. If this is the case, you shouldn’t bill the injection separately.
• If your anesthesia provider removed the epidural catheter after the delivery and determined later that day to administer an epidural blood patch, you can report it. Submit 62273 (Injection, epidural, of blood or clot patch) and include documentation of why the procedure was necessary. Include the appropriate diagnosis codes such as 668.8x (Other complications of anesthesia or other sedation in labor and delivery) and 997.09 (Other nervous system complications). The payer might also require a -59 modifier (Distinct procedural service) to show this was a separate service.