Anesthesia Coding Alert

Question: Is insertion of a Foley catheter considered part of the basic anesthesia service? The anesthesiologist inserted the catheter before performing lumbar decompression. I haven't seen any information about NCCI edits bundling the services (or anything regarding base units), but I want to be sure before I bill them.

Delaware Subscriber

Answer: In this case, your physician performed the procedure (disk decompression) instead of providing anesthesia during a procedure that another physician performed. Because of this, you'll report code 51702 (Insertion of temporary indwelling bladder catheter; simple [e.g., Foley]) as a surgical service and charge a flat fee instead of billing time units as you do for anesthesia services.

A follow-up question to consider is: Could you charge for the service if the anesthesiologist placed the catheter and provided anesthesia but did not perform the lumbar decompression?

The answer to this question is no, except in special circumstances. Routine catheter placement in the operating room is not a physician-billable service. Instead, most carriers consider this a nursing service (like starting an IV). That means carriers only pay for catheter placement if the staff encounter problems requiring a physician's skill such as a urethral stricture.