Anesthesia Coding Alert

Question: The anesthesiologist wrote "spinal astramorph" on the charge sheet. How should I code this? 


Kentucky Subscriber

Answer: Astramorph is a brand of spinal/epidural morphine, so you code it as an epidural -- if he administered the astramorph as part of a separate procedure for post-op pain management. If he administered the epidural as part of a procedure's anesthesia technique, you cannot bill it separately.

If you are able to report the astramorph administration, base your code on the type of epidural and the injection's location:

For a single injection, report 62310 (Injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; cervical or thoracic) or 62311 (... lumbar, sacral [caudal]).

For continuous infusion, report 62318 (Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; cervical or thoracic) or 62319 (... lumbar, sacral [caudal]).