Neurosurgery Coding Alert

Do not bill for injections or infusions in spine with left atrial hemodynamic monitoring.

The latest round of CCI edits (18. 2, effective July 1) bundles spinal injections and infusions with 0293T (Insertion of left atrial hemodynamic monitor; complete system, includes implanted communication module and pressure sensor lead in left atrium including transseptal access, radiological supervision and interpretation, and associated injection procedures, when performed), so you'll want to update your coding for these procedures. There are no circumstances in which you may report the two together.

The affected spinal injection/infusion codes include the following:

• 62310 (Injection[s], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic)
• 62311 (Injection[s], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid; lumbar or sacral [caudal])
• 62318 (Injection[s], including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], not including neurolytic substances, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic)
• 62319 (Injection[s], including indwelling catheter placement, continuous infusion or intermittent bolus of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], not including neurolytic substances, includes contrast for localization when performed, epidural or subarachnoid; lumbar or sacral [caudal])

"The bundling of imaging and anesthetic procedures with the definitive procedure is becoming the norm for new and revised CPT® codes," says Gregory Przybylski, MD, director of neurosurgery, New Jersey Neuroscience Institute, JFK Medical Center, Edison. "Even existing procedures that are typically performed together are being gradually rebundled by CPT®."