Anesthesia Coding Alert

Question: How should I report anesthesia and pain services provided by two physicians during a procedure (they're from the same group)? One administered the anesthesia, and the other implanted a pump.

Kentucky Subscriber

Answer: You'll need to report each physician's services on a separate claim. Report the anesthesia services with 00630 (Anesthesia for procedures in lumbar region; not otherwise specified) and the appropriate time units. Code the second physician's work with 62362 (Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming). Include a note such as "Surgeon fee for pump implant" in the description. Remember that you won't charge time units for this part of the procedure because this physician acted as the surgeon.
 
Sometimes when the pain physician performs a more extensive procedure under anesthesia (such as disk-ography or IDET), consider reporting the anesthesia provider's service with 01991 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; other than the prone position) or 01992 (... prone position). Commercial carriers often reimburse for these codes, but Medicare requires a medically necessary diagnosis to support administering anesthesia during the procedure.