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Cervical Epidural

  1. #11
    Default on Q Ice
    Exam Training Packages
    Julie,

    So what you are saying is an anesthesologist who is doing the 62319 for pain management (lower back pain) and not associated with post operative pain, should be covered. Or do you feel that it would be considered not medically necessary.

    Thank you for any help you can give me concerning this issue. Our doc wants to move foward with this but I am not comfortable in stating that we would be paid. Even the rep for the On Q ice gives us a letter for Medicare "ABNs" and commerical payors that state it may not be medically necessary.

    Have you heard of anyone being paid for this procedure?

  2. #12
    Default
    We do continuous epidurals for postop and post-trauma pain. My services are inpatient. Our Medicare carrier (WPS) has an LCD but we have no problems meeting the medical necessity diagnoses. Check to see if your carrier has an LCD. In addition, I have not had any payment issues with any other payers.

    Julie, CPC
    Last edited by jdrueppel; 02-16-2009 at 02:13 PM.

  3. #13
    Default On Q Ice
    Julie,

    I agree, we have not had any problems with receiving payment for the procedure when it is done in addition with a surgical procedure for post operative pain, but this physician wants to do it as a stand alone procedure for back pain. That is where I am having trouble.

  4. #14
    Default
    kknapp,

    Will these be inpatient services? I have billed continous epidural services for as stand alone procedure (i.e. thoracic for rib fractures OR lumbar for pelvic fracture) for acute trauma.

    It might be easier if we could personally connect on this. I sent you a private message.

    Julie

  5. Default 62310 vs 62318
    I have been following this thread and today my physician came to me stating he wanted to start billing 62319 for lumbar and 62318 for cervical epidural steroid injections done thru a catheter.

    He stated that there are occasions (not every time) that instead of just using fluoro to find needle placement and do a single injection, he may thread a catheter and insert the medication thru it. Once the medication infiltrates, he removes catheter. I read 62318/62319 as catheter placement with continuous infusion or intermittent bolus. He states that the injection is the intermittent bolus and then the catheter is removed. I can see his point, but I always thought these codes are for catheter placed for post-op pain management. For example, the catheter would be placed pre-operatively and then a bolus of pain meds given or even continuously infused later. And, of course, the catheter would not be used as the method of anesthesia for the surgery.

    62310 clearly reads NOT via indwelling catheter - so 62318 is the other choice. I just wanted some confirmation that this is correct. The responses seem to bounce back and forth.

    Many thanks!

    Laura

  6. #16
    Location
    NEW ORLEANS
    Posts
    954
    Default
    This forum really got me confused. One coder says this, the other says another. If the doc removes the catheter the same day seems like it does not qualify for continous infusion.Does anyone have any more info on this ?

  7. #17
    Default
    It can stil be a continous epidural infusion with catheter removed the same day.

    62310-62311 is a single injection.

    62318-62319 describes a continous infusion/bolus

    The difference in procedure notes and procedures are apparant regardless if the catheter is removed intact the same day.

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