Anesthesia Coding Alert

Question: Our anesthesiologist administered an epidural while a patient had bilateral above-knee amputations. He used the epidural as the mode of anesthesia during the procedure instead of as post-op pain management. Should I bill the epidural only, or should I report the anesthesia code for the amputations but not the epidural since it's not used for post-op management?


Texas Subscriber


Answer: Begin coding by choosing a surgical code for above-knee amputation, which for the situation you describe should be 27590 (Amputation, thigh, through femur, any level]). This crosses to anesthesia code 01232 (Anesthesia for open procedures involving upper 2/3 of femur; amputation).

You may be able to separately code and bill for epidural catheters used during a procedure, but this will depend on the circumstances. In the case you describe, the physician used the epidural as the mode of anesthesia during the procedure. Because of that, it is included in the anesthesia fee for code 01232 and is not separately billable.