# Difference between 01935-6 and 01991-2?



## bearybubba2008 (Jul 31, 2014)

We recently started doing MAC anesthesia for some of our patients. We have CRNAs come in and do the anesthesia. The doctor handles the procedures. We are doing ESIs, MBB, RF and kyphos. My doc wants us to use 01935 and 01936: anesthesia for percutaneous image guided procedures on the spine and spinal cord: diagnostic, therapeutic, respectively for all of our procedures. I feel that for the ESIs and the MBBs, that we should be using 01991 and 01992: anesthesia for diagnostic or therapeutic nerve blocks or injections: other than prone position and prone position, respectively.
Anyone have any insight in to these types of situations?

Thank you in advance for any help!


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## dwaldman (Jul 31, 2014)

A medial branch block would be a percutaneous image guided procedure since fluoroscopy or CT is required and inclusive. Although there is not written guidelines for the selection that I know of and other might have different methods of reporting.

For codes that required image guidance such as facet, transforminal, radiofrequency ablation, SCS trial, Vertebro/Kyphoplasty, I use 01936

For discogram or vertebral bone biopsy I use 01935

For interlaminar or caudual epidurals or other codes that do not specifically state they require image guidance I use 01992

For sphenopalatine I use 01991. 

When reviewing the base units both 01936 and 01992 have 5 base units. Whereas, 01991 has 3.

The perioperative temperature management PQRS measure fall under 01935 or 01936, where as it does not for 01992 or 01991. Typically you are reporting 4256F under 60 minutes

The above has worked for me, I believe UHC states that they don't cover 01936 and one Medicaid carriers requires a medical necessity form to filled out for 01936. So 01936 does have it's appeal time sometimes longer than the actual minutes of anesthesia. Nevertheless, the above works for me but every one has a different preference on their interpretation of use of these codes for pain management procedures under sedation.


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## bearybubba2008 (Aug 1, 2014)

*Thank you!*

Thank you so much for your response and help. It was extremely helpful and I really appreciate it.


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