Friday, July 9, 2010

Postoperative pain control - CPT 62310,64415,64449

Postoperative Pain Control Procedures

When provided principally for postoperative pain control, peripheral nerve injections and
neuraxial (spinal, epidural) injections can be separately reported on the day of surgery using the
appropriate CPT procedure with modifier -59 (Distinct Procedural Service) and 1 unit of service.

Examples of such procedures include:

62310-62319     Epidural or subarchnoid injections
64415-64416     Brachial plexus injection, single or continuous
64445-64448    Sciatic or femoral injections, single or continuous
64449               Lumbar plexus injections, continuous

These services should not be reported on the day of surgery if they constitute the surgical
anesthetic technique.

NOTE: Modifier 59 requires that the medical record substantiate that the procedure or service
was a distinct or separate services performed on the same day.


Daily Management of Continuous Pain Control Techniques

Daily hospital management of continuous epidural or subarachnoid drug administration is
reported using CPT code 01996 (1 unit of service daily). This code may be reported on the first
and subsequent postoperative days as medically necessary.

When continuous block codes 64416, 64446, 64448, or 64449 are reported on the day of surgery,
no additional reporting of daily management is permitted during the following ten days (10 day
global period). When these injections procedures constitute the main surgical anesthetic and are
therefore not separately reported on the day of surgery, subsequent days’ hospital management
is reported using the appropriate hospital visit code (99231-99233).

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