Anesthesia Coding Alert

Question: Our anesthesiologist placed a lumbar plexus catheter for anesthetic, and made visits to check on the patient for several days afterward. Should we report 01996 or 64449?

Mississippi Subscriber

Answer: If the catheter placement was the only service the anesthesiologist provided, code with 64449 (Injection, anesthetic agent; lumbar plexus, posterior approach, continuous infusion by catheter [including catheter placement]). Code 64449 no longer has any associated global days, and an evaluation and management (E/M) code that meets the documented service can be reported for the patient visits.

If the anesthesiologist placed the catheter primarily for anesthesia administration during surgery, however, then you only report the appropriate anesthesia code(s) for the initial date of service.

Double check: Before filing a claim with 64449, verify whether your payer has published guidelines for continuing infusions. Some payers consider these services medically unnecessary and/or investigational.

Unavailable: CPT® does not include a specific code for "daily" management of a plexus nerve catheter. Code 01996 (Daily hospital management of epidural or subarachnoid drug administration) is not appropriate in the situation you describe, because the code specifically addresses epidural and subarachnoid catheters. If your provider's documentation meets requirements for an E/M code, you'll usually choose the appropriate code from CPT®'s E/M section for catheter follow-up in these situations.