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Anesthesia Coding Alert

READER QUESTION ~ Add Modifier 59 to CSF Drain Catheter

Published on Fri Jan 06, 2006

Question: Our anesthesiologist placed a cerebral spinal fluid (CSF) drain catheter while providing anesthesia during a vascular procedure. Can we report both services?

Kansas Subscriber Answer: Yes, you should be able to report both services -- as long as your anesthesiologist did not use the CSF drain catheter for something related to the anesthesia administration.

The most common vascular procedures using spinal cord CSF drainage are elective repair of a thoracic aneurysm or dissection of the aorta. Report endograft replacement with the most appropriate code from 33881-33891 in CPT's Endovascular Repair of Descending Thoracic Aorta section. Choose the best code from 33860-33877 in the Thoracic Aortic Aneurysm section for open repair. Procedures in this section range from ascending aortic graft or transverse arch graft to repair of a thoracoabdominal aortic aneurysm with graft.

Because the CSF drain catheter placement is separate from the procedure's anesthesia, append modifier 59 (Distinct procedural service) to the endograft or open repair code.  
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