Anesthesia Coding Alert

Reader Questions:

Pre-Op Lumbar Epidural is Payable

Question: I have a case where my anesthesiologist did a pre-operative lumbar epidural before he administered general anesthesia. Why would he do that? Can we bill for this procedure? Georgia SubscriberAnswer: You can bill for a pre-operative lumbar epidural using 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]). Don't miss: Append modifier 59 (Distinct procedural service) to 62319. A lumbar epidural can be done for either postoperative pain management or as the anesthesia, so you would need modifier 59 to show that the epidural was done separate from the anesthesia.You should also include documentation from the surgeon that he requested the lumbar epidural be placed for the management of post-operative pain. This is a necessary component, and [...]
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