Anesthesia Coding Alert

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 Subscriber

Answer: 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 your claim may be denied without it.

-- Answers to You Be the Coder and Reader Questions were provided by Scott Groudine, MD, an Albany, N.Y., anesthesiologist, and Kelly Dennis, MBA, ACSAN, CANPC, CHCA, CPC, CPC-I, president of Perfect Office Solutions in Leesburg, Fla.