Reimbursement Advisor

Placing an ON-Q: Incidental to surgery?

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QCan I bill for placing an ON-Q device during surgery?

AThe ON-Q Elite (I-Flow Corporation, Lake Forest, Calif) is a system that automatically delivers local anesthesia into a surgical incision. It consists of a small electronic, reusable pump that has a single-use, disposable bag and tubing set to hold the anesthetic, plus a tiny tube to deliver it.

The only work required for this system is placing the tube into the incision site before closing. The company recommends using code 58999 (Unlisted procedure, female genital system [non-obstetrical], for placement of needles and catheters) for non-Ob procedures and 59899 (Unlisted procedure, maternity care and delivery) for obstetric surgery.

Reimbursement will depend on the payer’s policy regarding placing catheters during surgery: Many hold the opinion that this is incidental to the procedure. However, I’m told that on appeal Aetna, Avmed, and Cigna HMO have reimbursed for placing the catheter, but United and Blue Cross/Blue Shield have not.

You can also bill for the system itself if you—not the hospital—supplied it to the patient.

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