Anesthesia Coding Alert

Question: How should we report the diagnosis for billing 62318 or 62319 with modifier 59 at the time of surgery? Should we report a pain diagnosis, or the same diagnosis used for anesthesia?

 
Mississippi Subscriber
 

Answer: In the past, most coders reported V45.89 (Other postprocedural status; other) or V58.49 (Other specified aftercare following surgery) to indicate postoperative pain management, and then included a diagnosis indicating the pain's location (such as 719.46, Pain in joint; lower leg) for knee pain.

Some of your coding options changed, however, when ICD-9 2007 added a new category of postoperative pain codes (338.xx, Pain, not elsewhere classified). Many coders--and payers--now prefer a choice form 338.1x for postoperative pain, particularly 338.18 (Other acute postoperative pain). Some carriers and payers have not updated their acute pain coverage policies to include the new ICD-9 codes, so they might still require a V code in these situations.

Because of these inconsistencies, verify your payers' policies so you can follow their individual guidelines.