Anesthesia Coding Alert

Question: Our pain specialist placed a patient's lumbar epidural catheter on Monday and administered a non-neurolytic substance. The patient returned for follow-up injections on Wednesday and Thursday before the physician removed the catheter on Friday. How should we code this care? California Subscriber             Answer: For this procedure, report 62319 (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; lumbar, sacral [caudal]) for the catheter placement/epidural insertion on Monday.       CPT does not include a code for repeat bolus injections through an existing epidural catheter. Because of this, report the follow-up days with either 64999 (Unlisted procedure, nervous system) or an E/M service from 99212-99215 (Office or other outpatient visit for the evaluation and management of an established patient ...) based on the physician's documentation.             Note: The E/M service code includes catheter removal, so you shouldn't code removal separately.