Anesthesia Coding Alert

Question: How do I code an epidural blood patch procedure on the same day as labor and delivery? Should I include a modifier?

Oklahoma Subscriber

Answer: Epidural blood patches are administered to stop a spinal fluid leak that a spinal needle may have caused. The provider injects some of the patient's own blood to seal the leak and relieve pain.

Administering a blood patch on the same day as labor and delivery is unusual because most physicians try to manage spinal headaches conservatively before turning to an invasive treatment. Before coding the blood patch procedure, double check some things:

• Ensure that what you call a blood patch wasn't simply injecting blood through the epidural catheter before removing it after labor and delivery. If this is the case, you shouldn't bill the injection separately.
• If your anesthesia provider removed the epidural catheter after the delivery and determined later that day to administer an epidural blood patch, you can report it. Submit 62273 (Injection, epidural, of blood or clot patch) and include documentation of why the procedure was necessary. Include the appropriate diagnosis codes such as G97.0 (Cerebrospinal fluid leak from spinal puncture), G97.1 (Other reaction to spinal and lumbar puncture), or O75.9 (Complication of labor and delivery, unspecified).