Anesthesia Coding Alert

Question: Our anesthesiologist administered a single injection intrathecal block during a patient’s inguinal hernia repair. The injection was to L2-L3. I know I would report 00400 if the anesthesiologist had used general anesthesia but I’m not sure how to report the intrathecal block. What do you recommend?

Minnesota Subscriber

Answer: Before coding the intrathecal block, verify that it was used as part of postoperative pain management rather than as the mode of anesthesia during the surgery.

If the block was intended only for post-op management, submit 62322 (Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance) with diagnosis G89.18 (Other acute postprocedural pain). 

If, however, the nerve block was used as the primary mode of anesthesia, the mode would be regional. You would report that by crossing the procedure code 49650 (Laparoscopy, surgical; repair initial inguinal hernia) to the appropriate anesthesia code 00840 (Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified).