Anesthesia Coding Alert

Question: How should I code a pain-pump insertion when two physicians from the same group are involved in the procedure? One provided the anesthesia, and the other implanted the pump.

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Answer: Coding for the physician implanting the pump is a cake-walk: Simply report code CPT 62362 (Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming). But choosing a code for the administration of the anesthesia isnt as easy.
 
The ASA Crosswalk says to report the anesthesia portion with the five-unit code 00300 (Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified) and the applicable time units, but other coding sources point you in other directions. For example, some anesthesia coding books recommend 00620 (Anesthesia for procedures on thoracic spine and cord; not otherwise specified) at 10 units plus time or 00630 (Anesthesia for procedures in lumbar region; not otherwise specified) at 8 units plus time. Check the carriers guidelines so you can report it correctly.
 
Be sure to report Type of Service 2 (surgical service) on the claim for the pump insertion instead of the usual 7 for anesthesia care. Some coders suggest adding a note such as Surgeon fee for pump implant to the claim to alert the carrier that youre reporting a surgical service instead of anesthesia.