Anesthesia Coding Alert

Question: Can we bill for 64448? How should we report it if the patient comes in as an outpatient for the catheter placement, then goes home with it in place and removes it himself at home?


Connecticut Subscriber

Answer: If the physician places the catheter for postoperative pain management in conjunction with a separate anesthetic administered for the surgery, bill it as a flat fee with 64448 (Injection, anesthetic agent; femoral nerve, continuous infusion by catheter [including catheter placement] including daily management for anesthetic agent administration) and append modifier -59 (Distinct procedural service).
 
If the catheter placement is the only procedure performed during the session, do not append modifier -59. Remember the placement has a 10-day global period.

If the physician uses the catheter to administer anesthesia (not analgesia) during the procedure, report an appropriate anesthesia code for the surgery instead: 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). 

You Be the Coder and Reader Questions were answered by Terry Celestino, CPC, with Tejas Anesthesia in San Antonio; and Tonia Raley, CPC, with Medical Information Management Solutions in Phoenix.