Anesthesia Coding Alert

Question: If general anesthesia is administered and an epidural catheter is placed for post-op pain control, can we charge for epidural placement on the day of surgery (62319-59, injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substances, epidural or subarachnoid; lumbar, sacral [caudal]-distinct procedural service), and then 01996 (daily management of epidural or subarachnoid drug administration) for each day following? If the epidural is placed for the anesthetic we would not charge for 62319, but only 01996 for post-op days. Would there be no charge for the day the catheter is pulled?

Jan Wirtz, Specialty Billing Services, Wacona, Minn.

Answer: If you have the documentation to show that the epidural catheter was placed at a different time of day than the initial anesthesia, you can bill the procedure with the -59 modifier. Otherwise, you are correct in coding only 62319 for the initial placement and 01996 for follow-up days. There is no charge for removing the catheter.

Note: The code formerly used in this situation was 62279, which was deleted from CPT 2000. Coders should now use 62319 instead.