Anesthesia Coding Alert

Question: What anesthesia codes should we cross to for injections 62310, 62311, and 64483?

Nevada Subscriber

Answer: Physicians don't typically need to administer anesthesia when they perform epidural placements with 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 (... lumbar, sacral [caudal]). The current ASA Crosswalk does not list applicable anesthesia codes, so you might want to check your payer's guidelines for instructions.

You have a couple of choices for an anesthesia code related to 64483 (Injections], anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance [fluoroscopy or CT]; lumbar or sacral, single level). The primary cross code is 01936 (Anesthesia for percutaneous image guided procedures on the spine and spinal cord; therapeutic). The secondary cross code is 01935 (... diagnostic). You'll need to check your provider's intention in administering the epidural to determine whether to report the diagnostic or therapeutic code.

Document: For any of these procedures, verify that your provider clearly documents why the patient needed anesthesia.

Note: In the past, codes 62310 and 62311 crosswalked to 01991 and 01992. In 2011, however, the American Society of Anesthesiologists added a statement to the Relative Value Guide indicating that these procedures usually don't require anesthesia. Certain circumstances might necessitate providing separate anesthesia during the epidural administration, such as when the patient has Parkinson's disease.