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Editor's Note: This article by Paul Cadorette, director of education for mdStrategies, originally appeared in The Coding Advocate, mdStrategies free monthly newsletter. Sign-up to receive this newsletter by clicking here.
As the year 2011 draws to a close an old expression comes to mind: "As one door closes, another door opens," and that means it's time for the 2012 CPT changes. The code set that I'd like to discuss is 62310-62319, and the reason for that is a revision to the CPT code definitions and clarification of the coding guidelines when an injection is performed utilizing a catheter instead of a needle.
Previously, code 62310-62311 read "Injection, single (not via indwelling catheter)…. This code was revised in 2012 and now reads "Injection(s), of diagnostic or therapeutic substances…. Note that the 2011 code was for a single injection and the revision being made for 2012 is adding the plural alternative to the term "injection" meaning that the code now represents one or more injections at the lumbar or sacral level. This seems to be in keeping with CPT Assistant (Nov. 8) which stated that 62311 would not be reported more than once on a given date of service because any injected substance(s) would diffuse into the entire area — therefore it would not be necessary to inject both sides or multiple levels.
When it came to a catheter-based procedure for epidural injections, there was always a difference of opinion with some physician practices coding the 62318-62319 codes while the ASCs were reporting the 62310-62311 codes. Since the holiday season is about peace, harmony and goodwill towards man, the injection guidelines have been editorially revised and now practices and ASCs won't have to argue about which code should be used.
When a catheter is placed for the purpose of administering a single injection or injecting substance(s) at more than one level and then the catheter is removed, the injection procedure should be treated in the same manner as if a needle had been used with the correct code being either 62310 or 62311 depending on where the needle or catheter is inserted into the body. 62318 or 62319 should only be reported when the catheter is left ns place (more than a calendar day) to continuously deliver substance(s) or to deliver substance(s) by intermittent bolus.
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