Anesthesia Coding Alert

Question: Our physician used X-ray under fluoroscopy to complete what he called an "epidural catheter placement" for a patient with three fractured ribs. How should I code this?

Indiana Subscriber

Answer: First, check the documentation to verify whether your physician placed an epidural catheter instead of administering a single epidural injection via a temporary catheter, because that difference will guide your coding. You'll also need to know the specific anatomic insertion location because that's what your coding choices center on:

• 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

• 62311 -- ... lumbar, sacral (caudal)

• 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

• 62319 -- ... lumbar, sacral (caudal).

Bonus: You can report fluoroscopic guidance for an epidural steroid injection (ESI) with 77003 (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic therapeutic injection procedures [epidural, transforaminal epidural, subarachnoid, paravertebral facet joint, paravertebral facet joint nerve, or sacroiliac joint], including neurolytic agent destruction).