You Be the Coder:
Lumbar Puncture and EEG
Published on Fri Feb 01, 2002
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Anesthesia was performed on a patient who had a lumbar puncture (62270*, spinal puncture, lumbar, diagnostic) and an electroencephalogram (EEG) (95816, EEG including recording awake and drowsy [including hyperventilation and/or photic stimulation when appropriate]). Which anesthesia code is valid for these?
North Carolina Subscriber
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Answer: Use 00635 (anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture), which was added to CPT Codes in 2001 to report anesthesia for lumbar punctures.
Crosswalk 2001 lists 01961 (anesthesia for diagnostic or therapeutic nerve blocks and injections when block or injection is performed by a different provider) as the cross code for lumbar puncture, but this code was not accepted by many carriers because it was not in CPT 2001. Although CPT 2002 added 01961, it was changed to describe obstetrical services, "anesthesia for cesarian delivery only," rather than nerve blocks and therefore is inapplicable to this situation. Many coders also thought 01961 was inappropriate for this situation because it dealt with nerve injections rather than lumbar punctures.
Report the lumbar puncture code, but not the EEG. Code 95816 states "awake and drowsy" meaning the patient could be sedated rather than asleep. Therefore, an anesthesiologist would be unnecessary. Most carriers will not pay for anesthesia for these procedures unless the patient is a very small child or other exceptional circumstances apply.
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