Anesthesia Coding Alert

Question: Our physician administered a three-level lumbar injection for pain management. Which modifiers should I append for correct submission?


Florida Subscriber

Answer: Report each injection with 62311 (Injection, single [not via indwelling catheter], 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]).

Appending a modifier to the second and third injections gets tricky because coders have different opinions on whether 51 (Multiple procedures) or 59 (Distinct procedural service) is more accurate.

Some coders believe that modifier 59 is accurate because the different levels of injections constitute the "different site or organ system" mentioned in CPT's modifier appendix. Other coders say modifier 51 is better because your physician treated separate levels with separate injections.

Best bet: Ask your carrier whether its guidelines advise using modifier 51 or 59. Whichever route you choose, include the physician's procedure notes so the carrier knows you're reporting multiple injections.