Anesthesia Coding Alert

Question: I know that Medicare will not cover services associated with epidural patient-controlled analgesia (PCAs), so I assume that Medicare won't cover the catheter placement either. But if the note describing the epidural placement does not indicate that it is for PCA, should I bill for the placement? Oklahoma Subscriber Answer: If you're looking at catheter placement with no associated daily management, bill for it. Use either 62318 (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 substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; cervical or thoracic) or 62319 ( lumbar, sacral [caudal]) with modifier -59 (Distinct procedural service) to indicate that the catheter placement and daily management are separate services. Also include the appropriate ICD-9 code for pain (generally the anatomic site).