# Field Avoidance



## jsecor (Sep 5, 2013)

Can anyone advise or provide back up documentation on the rules of Field Avoidance?  What is required for documentation by the anesthesiologist so that we can bill for the field avoidance, and has anyone been paid for using it.  Modifier 22/23 preferred.
 Thanks in advance


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## BarbaC (Sep 5, 2013)

*Field avoidance*

Field avoidance is built into all procedures on the facial area - these are 5 unit procedures for that very reason.


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## jsecor (Sep 5, 2013)

What IF for some reason the base was less than a 5 would it be appropriate to utilize a modifier to have that base increased up to a 5?  OR is there another way to handle this.  We obviously want the doc to get paid for his services, but not sure how to advise the doc on the documentation we may need to do so. 

I am trying to find an example but I am not sure I will be able to do so. 
Thanks for the information.


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## Michele Hannon (Sep 5, 2013)

The ASA Relative Value Guide reports that "Any procedure around the head, neck, or shoulder girdle, requiring field avoidance or an procedure requiring a position other than supine or lithotomy, has a minimum Base Value of 5 regardless of any lesser base value assigned to such procedure in the body of the Relative Value Guide". Page xi
An example of this would be: ankle tendon repair CPT 27658 which crosses to 01470 with a base unit of 3. This procedure is commonly (not always) done in the prone position. If indeed, your anesthesia provider documented the prone position, that is acceptable to bump the BV to 5.....no modifier necessary.

Many times during ENT surgery the "table is turned"......meaning the OR table is unlocked and turned 45,90,maybe 180 degrees......getting our providers to specifically document the number of degrees will only strengthen their case for the additional base units. Communicate with your providers......."Please help me understand what you mean by this, Dr. X"
Detailed documentation can only help your cause, especially when you find it necessary to appeal.


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## jsecor (Sep 5, 2013)

ok that makes sense !! Thank you and I will be approaching our providers with that documentation request.


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## FractalMind (Jul 15, 2016)

*More field avoidance examples needed*

Hi, 

What about "Head 90 degrees away" and "90 degrees airway avoid" ? Is that supportive documentation of field avoidance?

Thank you.


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