Wiki problems being paid for 62319 done in the office

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PEH350

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We are a Pain Mgmt practice, part of the Anesthesiology Dept, and just started to perform continuous epidural infusions in the office. We are billing 62319, but are now receiving denials. Are we coding this incorrectly?

The patient is prepped basically the same as for a Lumbar epidural steroid injection, but the catheter with continuous infusion of anesthetic is left in place for 3 hours with monitoring. :confused:
 
The code 62319 should only be used if the catheter is left in place more than one calendar day. If it's less than a calendar day you should use 62311. This is per CPT guidelines pg. 349-350.
 
I should have mentioned that the above guidance from CPT can cause payers to look for an inpatient place of service on your claims. More than one calendar day implies that the patient is inpatient. We have had occasions where a patient has had a catheter placed and has returned to the pain clinic each day to have it dosed and/or evaluated, but that's rare. So, your claims may deny for invalid place of service.
 
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