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Topic: Guidance explains continuous infusion

Ambulatory Surgery Reimbursement Update, July 15, 2008

Coders often inappropriately report continuous infusion through a catheter placed in the epidural region, says Lolita M. Jones, RHIA, CCS, principal of Lolita M. Jones Consulting Services in Fort Washington, MD.

Many coders think that if they see a reference to a catheter for an epidural block, they should automatically assign this code. However, to use these codes, a physician must have placed the catheter and the patient has to undergo continuous infusion of some substance for a period of hours or days.

“Just because a catheter is used doesn’t mean it is continuous infusion,” Jones says. “Continuous infusion over a period of hours is the key.”

The January 2000 CPT Assistant states:

For codes 62318 and 62319, a catheter is threaded through the needle and placed in the subarachnoid or epidural space. Through this catheter, a continuous infusion is started for several hours or days. Occasionally, as part of a detailed diagnostic or treatment regimen, multiple (3 or more) injections might be given through this catheter over a period of hours or 1–2 days. These multiple injections often involve different substances, such as placebo injection or varying amounts of narcotic.

Editor’s note: This topic is from the July 2008 issue of Ambulatory Surgery Coding and Reimbursement Insider.

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