Anesthesia Coding Alert

Question: The anesthesiologist worked with the oncologist on a case involving a lumbar puncture and intrathecal chemotherapy. The anesthesiologist completed the lumbar puncture and the oncologist completed the chemotherapy administration. Code 96450 includes both services, so we tried filing with modifier 80 and modifier 62. The payer denies everything. How should we report the procedure for both physicians?

Answer: Does the documentation indicate why the bundled service was provided separately by the anesthesiologist? If it was medically necessary to separate the service, your best option may be to report the therapeutic lumbar puncture with documentation to support the separation of bundled services.

The oncologist submits 96450 (Chemotherapy administration, into CNS [e.g., intrathecal], requiring and including spinal puncture) and the anesthesiologist may report 62272 (Spinal puncture, therapeutic, for drainage of cerebrospinal fluid) for his service.