Neurosurgery Coding Alert

Question: Our physician inserted a lumbar drain and wants to leave it in place for several days. Our physician has listed 62272 as the procedure code. Our physician makes daily inpatient visits. How should we report for these daily services? Are there any guidelines for these services?

Washington Subscriber

Answer: The daily management code 01996 (Daily hospital management of epidural or subarachnoid continuous drug administration) sometimes is appropriate for follow-up management care, but doesn’t apply in this situation because it refers to management of a continuous infusion of a medication. Your physician is instead checking the functioning of the lumbar cerebral spinal fluid drain.

Code 62272 (Spinal puncture, therapeutic, for drainage of cerebrospinal fluid [by needle or catheter]) doesn’t have any associated global days. If the physician meets the documentation requirements, then you can bill the appropriate E/M code for a subsequent hospital care visit, 99231 (Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components … Usually, the patient is stable, recovering or improving. Typically, 15 minutes are spent at the bedside and on the patient’s hospital floor or unit) – 99233 (………….. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient’s hospital floor or unit).