Anesthesia Coding Alert

Reader Questions:

Look for Medical Necessity for Lumbar Epidural

Question: My anesthesiologist recently inserted a pre-operative lumbar epidural catheter prior to providing general anesthesia. I'm wondering why he performed the insertion that way, at that particular time. I'm also wondering, of course, if I can bill for it. What codes should I use? Florida Subscriber Answer: You will use 62319 (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; lumbar, sacral [caudal]) to report this procedure. You should append modifier 59 (Distinct procedural service) to show the catheter procedure was separate from the anesthesia service. Your anesthesiologist's documentation should also show that fact, in order to prove medical necessity. A lumbar epidural is traditionally inserted preoperatively, when the patient is able to assume the correct position for the insertion. This is [...]
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