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Anesthesia Coding Alert

Practices Hit Hard by New Subsection, Deletions and Revisions
Released in November 2001, the 2002 version of CPT includes many changes that af... Read more
Use 01996 for Management of Epidural Catheters Unless E/M Requirements Fulfilled
Pain-management physicians are sometimes called in to manage postoperative p... Read more
Patient-Controlled Anesthesia Is Part of E/M
The American Society of Anesthesiologists (ASA) lists billing Medicare for patient-co... Read more
CPT 2002 Adds New Trigger-Point Injection Codes, Revisions
CPT 2002 revised 20550, which should no longer be used to report trigger-poi... Read more
Use Specific Nerve Destroyed as Key to Radiofrequency Coding
" Increasingly, pain specialists use radiofrequency (RF)... Read more
News Brief:
CCI 7.3 Deletes Version 7.2 Fluoroscopy Edit
Version 7.3 of the Correct Coding Initiative deleted a comprehensive edit that wa... Read more
Learn APLD Basics To Reap Benefits
Automated percutaneous lumbar diskectomy (APLD) or laser-assisted disk compressio... Read more
Update:
CCI Edits Bundle 76005 Incorrectly
A recent round of CCI edits bundled 76005 (fluoroscopic guidance and localization of ... Read more
Reader Question:
Diskography Versus Diskograms
Question: I am having trouble with workers'-compensation and auto-insurance companies ... Read more
Reader Question:
Use Modifier -22 for Altered Surgical Fields
Question: I have heard that modifier -60 (altered surgical fields) should no longer be u... Read more
Reader Question:
Radiological Report for Epidurograms
Question: Does a physician have to write a separate report for an epidurogram?South Ca... Read more
Reader Question:
Bilateral Lumbar Facet Injections
Question: How should I bill Medicare to get full payment for lumbar facet block injectio... Read more
Reader Question:
Split Time for Anesthesia
Question: Our anesthesiologists often split time in surgery. One of our anesthesiologist... Read more
Reader Question:
Reimbursement for Emergency Services
Question: Our practice has difficulty getting paid by Medicare and other carriers for em... Read more
Reader Question:
Discontinued Procedure
Question: A  patient was given general anesthesia in preparation for an open-heart ... Read more
Reader Question:
MAC for Caudal Epidural Blocks
Question: Which anesthesia code and modifier should I use for monitored anesthesia care ... Read more
You Be the Coder:
MAC for LESI
Test your coding knowledge.  Determine how you would code this situation bef... Read more
Identify and Document Diagnosis and Medical Necessity for EPS, MRI and Endoscopy
Patients may receive anesthesia when undergoing certain diagnostic tests suc... Read more
Type of Procedure Determines Modifiers -78, -79 and -58
A fine line distinguishes the usage of modifiers -78 (return to the operating room for... Read more
News Brief:
CMS Releases ICD-9 Codes for 2002
Effective Oct. 1, 2001, CMS (formerly HCFA) implemented an updated and revised ICD-9 c... Read more
News Brief:
Mississippi Medicare Carrier Changes MAC Policy
In the September 2001 Medicare Provider News, published by Cahaba Government Benefits Ad... Read more
Reader Question:
Acute Normovolemic Hemodilution
Question: Our anesthesiologist performs a flat-fee procedure called acute normovolemic hem... Read more
Reader Question:
Inserting Screws and Performing Fusion
Question: Which CPT codes are used to report L4-5 syntheses screws/rods and L4-5 prolatera... Read more
Reader Question:
Disk Injections
Question: Disks L4-5 and L5-S1 were injected with a local anesthetic and a steroid follo... Read more
You Be the Coder:
Simultaneous Post-Op Billing
Test your coding knowledge.  Determine how you would code this situation before ... Read more
Level II Modifiers Describe Service Levels and Provider Roles
HCPCS 2001 states that modifiers should, or in some cases must, be used to identi... Read more
Seven Rules of Medical Direction
Before a case can be considered medically directed, CMS mandates that the anesthesiologi... Read more
Mutually Exclusive Codes Affected by Edits
The Correct Coding Initiative (CCI) edits 7.2 released in July 2001 included many... Read more
Reader Question:
Exam Before Fluoroscopy
Question: One of our pain management physicians performed an exam of a patients extremely ... Read more
Reader Question:
Conscious Sedation
Question: I know we can charge for conscious sedation (99141) in addition to gastrointesti... Read more
Reader Question:
IV Access
Question: What supporting diagnosis should be used for IV access by an anesthesiologist?Ma... Read more
Reader Question:
Endoscopic Resection
Question: How should I code for anesthesia during a procedure that was diagnosed as left e... Read more
Reader Question:
Catheter Placement
Question: Can I bill separately for a catheter placed by the medically directing anesthesi... Read more
Reader Question:
Jejunostomy Tube Removal
Question: Is there a way to code for the removal of a jejunostomy tube that was done und... Read more
Reader Question:
Transected Axillary Artery
Question: What is the correct anesthesia code for the repair of a transected axillary arte... Read more
Reader Question:
Different Anesthesiologists During Delivery
Question: How should we code if one anesthesiologist begins a labor epidural and anoth... Read more
Reader Question:
Myoblock
Question: Which code should be used to report Myoblock (botulinum toxin type B) for chem... Read more
Reader Question:
Vertobroplasty
Question: The crosswalk code for 22520 (percutaneous vertebroplasty, one vertebral body, u... Read more
Reader Question:
Numbing Before Anesthesia
Question: Our anesthesiologist uses xylocaine to numb the area before administering the dr... Read more
Reader Question:
Highest Specificity, or Match Exactly?
Question: Should a patient's diagnosis be coded to the highest level of specificity, or ... Read more
You Be the Coder:
Modifier -59
Test your coding knowledge.  Determine how you would code this situation before ... Read more
Avoid Common Pitfalls When Coding and Billing for Dorsal Column Stimulators
Dorsal (or spinal) column stimulation (DCS) is a treatment for patients with... Read more
Newest CCI Edits! Know the Changes that Will Affect Current Coding Habits
When the Correct Coding Initiative (CCI) edits (7.2) took effect in July, codes r... Read more
Six Tips To Optimize Payment for Facet Joint Injections
CPT Codes 2000 deleted two codes (64442 and 64443) for ... Read more
Preauthorization Is Critical for IDET Payment
Increasingly, commercial payers and some local Medicare carriers cover IntraDisc... Read more
Reader Question:
Incomplete LESI Included in Epidural
Question: The physician was going to do lumbar epidural steroid injections (LESI) under ... Read more
Reader Question:
Use Modifier -58 for Follow-Up Visits
Question: We use 63650 to report a trial implant of neurostimulator electrodes. This c... Read more
Reader Question:
Anesthesia, Pain Management Mix-Up
Question: When billing code 96530, is there an anesthesia unit charge for, say, three un... Read more
Reader Question:
Billing for Crossover Days
Question: How should anesthesia be coded for a procedure that spans two dates of service... Read more
Reader Question:
Piriformis Muscle TPI
Question: What are the most appropriate CPT and ICD-9 codes for a trigger point injectio... Read more
Reader Question:
Myelography Coding Without Radiologist
Question: An anesthesiologist performed a lumbar epidural injection with contrast dye and ... Read more
Reader Question:
Supporting Diagnosis: IV Access
Question: What supporting diagnosis should be used for IV access by an anesthesiologist?Fl... Read more
Reader Question:
Anesthesia for Orthotripsy
Question: Which code should I use for an orthotripsy (the ablation of a heel spur using la... Read more
Reader Question:
Long-Term Patient Care
Question: What is the best way to code for a patient with long-term ICU or CCU care, such ... Read more
Reader Question:
Anesthesia for Balloon Kyphoplasty
Question: Medicare will not pay for the anesthesia code that balloon kyphoplasty cross-ref... Read more
You Be the Coder:
Anesthesia or Surgical Codes for Epidurals
Test your coding knowledge.  Determine how you would code this situation before ... Read more
Coding Ventilator Management Outside Global Anesthesia Services
Beginning in 2001, CMS (formerly HCFA) bundled ventilation-management (VM) c... Read more
Separately Bill Post-Op Pain Management Ethically
Billing for an anesthesiologist's postoperative services -- such as... Read more
Use New, Specific Codes for Endovascular Repair of AAA
Until the release of CPT 2001, endovascular repairs for abdominal aortic aneurysm (AAA... Read more
Reader Question:
Billing for Monitoring Service
Question: A patient presented for an emergency colonoscopy. No sedation was used, but ou... Read more
Reader Question:
Coding for Prolotherapy
Question: How should we code prolotherapy?California Subscriber Answer: Prolotherapy,... Read more
Reader Question:
Billing for Second Anesthesiologist Assist
Question: One of our anesthesiologists encountered a patient who was very difficult to i... Read more
You Be the Coder:
Removal of Ear Tubes
Test your coding knowledge.  Determine how you would code this situatio... Read more
Procedural Stages for Intrathecal Pumps Provide the Key to Successful Coding
The three-stage process of using a permanent implantable pump (trial i... Read more
Intubation and Anesthesia for Laryngoscopy, Bronchoscopy
Laryngoscopies and bronchoscopies are performed fairly frequently, esp... Read more
Legislative Update:
CRNA Rule Postponed
... Read more
Reader Question:
Noninvasive Lumbar Punctures With MAC
Question: We use the new anesthesia code 00635 for noninvasive lumbar punctures requirin... Read more
Reader Question:
Diskography Billing
Question: When our pain management physicians do diskography and bill 62290* for each le... Read more
Reader Question:
Multiple TPI Coding
Question: Our physicians insist on billing for each trigger point injection they adminis... Read more
Reader Question:
Physician-owned Nerve-block Equipment
Question: Our physician performed a peripheral nerve block (lateral femoral cutaneous bl... Read more
You Be the Coder:
Sheathectomy
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
"You Be the Coder" Update:
Which Code Is Right for 15736
Because the answer to the May question ("Which anesthesia ... Read more
Get Paid for Office Visits and Consults
For many specialties, coding and billing office visits and consultations are routine. For ... Read more
Coding Retrobulbar Blocks Is as Challenging as the Procedure
Retrobulbar blocks (67500*), which surgeons sometimes request anesthesiologists to admin... Read more
Billing Fluoroscopy for Nerve Blocks and Destruction
With only two choices available, coding fluoroscopy associated with nerve blocks or destru... Read more
Reader Question:
Anesthesia for EEG
Question: How do we code anesthesia for an EEG? Maine Subscriber Answer: The only ... Read more
Reader Question:
21127 Versus 21215
Question: What is the difference between codes CPT 21127 and 21215? New Mexico Subsc... Read more
Reader Question:
Modifier -22 and Extra Units
Question: We know we can charge extra units for anesthesia procedures coded with modifier ... Read more
Reader Question:
Endoscopic Resection of Eustachian Tube Lesion
Question: How do I code for anesthesia during a procedure that was diagnosed as left eusta... Read more
Reader Question:
Anesthesia for Tubal Ligation
Question: Which anesthesia code should we use for CPT 58611 (postpartum tubal ligation),... Read more
Reader Question:
Mole Excision ICD-9 and CPT Codes
Question: What are the correct ICD-9 and CPT codes for excision of mole in scalp for ane... Read more
You Be the Coder:
Internal Jugular Catheter Replacement
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Procedure, Equipment, and Who Places Lines Determine Correct Coding for CABG
In 2001, anesthesiologists gained two codes for coronary artery bypass graft surgery (CA... Read more
Medicare Accepts Previously Denied Pain-management Codes
Are we getting reimbursed for all the pain- management services we offer in our ambulatory... Read more
Hurdle Anesthesia Diagnoses And Coding Roadblocks
By Barbara Johnson, CPC, MPCConsulting EditorAnesthesia historically has been difficult to... Read more
Code the Number of Trigger Point Injections by Muscle Groups
Trigger point injections (20550, injection, tendon sheath, ligament, trigger points or gan... Read more
Unless Used to Deliver Anesthesia, Epidural Catheter Placement Is Reimbursable
Medicare will pay for placement of an epidural catheter in addition to administration of... Read more
Non-Medicare Carriers May Pay For Conscious Sedation
Some injections can be very painful, requiring that the patient receive a sedative. For ex... Read more
Medicare Carriers Unlikely to Honor 99141 and 99142
Most local Medicare carriers, such as Empire Medicare Services in New Jersey and parts of ... Read more
Reader Question:
Morphine Injections
Question: We are having problems getting reimbursed for morphine injected through a pump, ... Read more
Reader Question:
Multiple Procedures
Question: Does modifier -51 apply to anesthesia? If so, how?Texas Subscriber Answer: You c... Read more
Reader Question:
Add-on Procedures
Question: Can we bill an anesthesia code for an add-on procedure, or is the anesthesia cha... Read more
Reader Question:
Joint Injection
Question: Our pain-management physician documented a sacroiliac joint injection, left side... Read more
Reader Question:
Bunionectomy
Question: Can you suggest the anesthesia and surgical codes for a bunionectomy (complete e... Read more
Reader Question:
Anesthesia Code for 64450*
Question: Is there an applicable anesthesia code for procedure 64450*? The primary procedu... Read more
Reader Question:
Prostate Volume Studies
Question: We conduct prostate volume studies in the OR because we can give the patient ane... Read more
Reader Question:
Central Venous Catheter
Question: We sometimes place a central line during a surgical case for IV access only, not... Read more
Reader Question:
Unusual Position
Question: How does anesthesia bill for unusual position of a patient on procedures with a ... Read more
Reader Question:
MAC for Biopsy
Question: How should we code monitored anesthesia care (MAC) for a bone marrow biopsy? The... Read more
Reader Question:
Fluoroscopy
Question: How do I code for fluoroscopy our anesthesiologist performed for a paralyzed d... Read more
Reader Question:
Monitored Anesthesia Care
Question: What diagnoses mandate the presence of an anesthesia provider during MAC sedatio... Read more
Reader Question:
Postoperative Pain Consults
Question: What documentation is necessary to perform and bill a postoperative pain consult... Read more
Reader Question:
Refilling and Reprogramming Pain Pump
Question: How do I bill for an in-office (owned and operated by the pain management specia... Read more
Reader Question:
Billing Facet Joints
Question: My physician performs a two-level facet injection of the L4 and L5 spine on a pa... Read more
You Be the Coder:
Grafting Procedures
Question: What anesthesia code corresponds with grafting procedure 15736 (muscle, myocutan... Read more
Turn RVU Discrepancies Into Reimbursement
Its a typical day in the billing/coding area of a busy anesthesia practice, and the conver... Read more
Prove Medical Necessity for Catheter Insertion Reimbursement
Fifteen to 20 percent of our physicians time is spent inserting catheters, says Mary Ann T... Read more
Modifiers Mean Reimbursement for Pain Management
Most payers will not reimburse for pain managementunless they have a precise description o... Read more
Reader Question:
Anesthesia Time
Question: How do we calculate anesthesia time, based on multiple starts and stops? The ane... Read more
Reader Question:
Regional Nerve Block
Question: If our anesthesiologist performs a regional nerve block in addition to general a... Read more
Reader Question:
Hemosonic 100
Question: Our anesthesiologist has begun using the Hemosonic 100. How should we bill for t... Read more
Reader Question:
Bis Monitor
Question: How do we bill separately for a bis monitor?Maryland Subscriber Answer: Anesthe... Read more
Reader Question:
Blood Patch
Question: What are the correct CPT Codes and ASA codes for billing a blood patch used to... Read more
Reader Question:
Daily Pain Management
Question: Some of the commercial carriers in our state deny 01996 for daily pain managemen... Read more
Reader Question:
Numbing Injections
Question: One of our anesthesiologists uses xylocaine to numb the area before administerin... Read more
Reader Question:
Jejunostomy Tube
Question: Is there a way to code for the removal of a jejunostomy tube that was done under... Read more
You Be the Coder:
Spirometry
Question: Our anesthesiologist wants to charge for a spirometry in addition to the anesthe... Read more
Learn Carrier MAC for GI Coding Rules for Better Reimbursement
Coding routine versus deep sedation for gastrointestinal (GI) procedures is challenging ... Read more
Use New Codes to Boost Pay for Percutaneous Vertebroplasty
Youll no longer have to use 01999 (unlisted anesthesia procedure[s]) to report percutane... Read more
Append P3-P5 Physical Status Modifiers for Reimbursement
  Latest on Physical Status Modifiers (P1-P6) from Codify&... Read more
CCI Edit Suspension May Lead To Additional Reimbursement
HCFAs recent temporary suspension of version 6.3 Correct Coding Initiative (CCI) edits, re... Read more
Reader Question:
RACZ Catheter Lysis: Adhesions/Epidurographies
Question: How do I code for a RACZ catheter lysis of adhesions and for epidurographies? ... Read more
Reader Question:
Coding IDET
Question: Our Medicare carrier in Florida considers intradiscal electrothermal therapy (I... Read more
Reader Question:
Modifier -27
Question: Ive heard conflicting opinions on whether the new modifier -27 will affect anest... Read more
Reader Question:
Different Anesthesia, Discontinuous Time
Question: A patient was scheduled for surgery with monitored anesthesia care (MAC), but a... Read more
Reader Question:
Ventilation Management and Subsequent Visits
Question: Can I bill ventilation management codes along with subsequent visit codes for IC... Read more
Reader Question:
Crosswalk for New Code 52343
Question: CPT 2001 includes a new code, 52343 (cystourethroscopy; with treatment of intra-... Read more
Reader Question:
Tibial Tubercle Excision
Question: What are the correct surgical and anesthesia codes for the excision of a tibial ... Read more
Reader Question:
Arthrogram and Closed Reduction
Question: Our anesthesiologist provided general anesthesia for a patient who had a closed... Read more
Reader Question:
Two Procedures, Two Locations
Question: A patient underwent a cystourethroscopy (52332, cystourethroscopy, with insertio... Read more
Reader Question:
Poor IV Access
Question: We were asked to provide anesthesia during routine care for a patient whose diag... Read more
You Be the Coder:
64605 Clarified
Question: Can you clarify the use of 64605? Does it crosswalk with 01961, the new anesthes... Read more
Get Paid for Arthroscopic, Laparoscopic and Wrist Ligament Procedures That Have No Codes
It is not uncommon for anesthesia providers to be involved with procedures that do not h... Read more
TIPS:
Know the Codes for Optimal Reimbursement
The insertion of a transjugular intrahepatic portal systemic shunt (TIPS or TIPSS) is a pr... Read more
2001 Anesthesia Conversion Factor Increased
The 2001 anesthesia conversion factor (ACF) for Medicare will be $17.83, not $17.26 as pre... Read more
Anesthesiologist Convicted of Fraud
An anesthesiologist was convicted recently of defrauding insurance companies. According ... Read more
Reader Question:
Neurolytic Block
Question: How do I code for a lumbar sympathetic neurolytic block with phenol or alcohol?... Read more
Reader Question:
Getting Dual Physicians Paid
Question: An anesthesiologist in our group sometimes performs a procedure that a surgeon u... Read more
Reader Question:
IV Along With Labor Epidural
Question: In addition to a labor epidural, can I bill for an IV I had to start because the... Read more
Reader Question:
Continuous Time or Two Procedures?
Question: An emergency hysterectomy patient was taken to recovery, where bleeding continue... Read more
Reader Question:
Brachial Plexus Catheter Anesthetic
Question: What code would you use for the placement of a continual catheter in the brachia... Read more
Reader Question:
ICD-9 Coding Help
Question: What are the correct ICD-9 codes for epidural fibrosis, lumbar facet joint dis... Read more
Reader Question:
Coding for Multiple Intervertebral Levels
Question: The anesthesiologist injected the L1/L2, L2/L3 and L3/L4 levels to perform a sym... Read more
Reader Question:
Port-a-Cath ICD-9
Question: A patient had a Port-a-Cath inserted for chemotherapy, and now it is leaking. ... Read more
Reader Question:
Refilling Programmable Pumps
Question: One of our anesthesiologists refilled a programmable pump (96530, refilling and... Read more
Reader Question:
Anesthesia for Status Asthmaticus
Question: If general anesthesia is given in the operating room to treat status asthmaticus... Read more
Reader Question:
Omentectomy Coding
Question: What anesthesia code would we use for laparoscopic resection portion of omentum ... Read more
Reader Question:
TAH and Abdominoplasty Coding
Question: A patient had a total abdominal hysterectomy (TAH) and an abdominoplasty. In tot... Read more
You Be the Coder:
Crosswalking Temporal Artery Ligation
Question: Can you help me convert CPT 37609 (ligation or biopsy, temporal artery) to an an... Read more
New Procedure Code Gains Optimal Payment For Botox Injections
Botulinum toxin A or botox, as its commonly known is being employed with increasing freq... Read more
Improve Your Bottom Line With Thorough Documentation
With so many requirements related to anesthesia documentation, its no wonder patient recor... Read more
News Brief:
New Anesthesia Conversion Factor for 2001
The 2001 Physician Fee Schedule, effective Jan. 1, 2001, was published in the November 1, ... Read more
Reader Question:
Femoral Nerve Blocks
Question: Is it OK to bill a femoral nerve block if the patient receives general anesthesi... Read more
Reader Question:
Double Lumen Catheter Placement
Question: The anesthesiologist placed a double lumen tube, a lung ventilation and fiberopt... Read more
Reader Question:
EP Procedures
Question: What is the best way to code electrophysiologic procedures (EP studies) for Medi... Read more
Reader Question:
Procedural Modifiers
Question: Recently we have received several claims denied as procedural modifiers required... Read more
Reader Question:
Bier Block Billing
Question: What code should be used for a Bier block on a patient who presented with ankle/... Read more
Reader Question:
Return to OR
Question: A patient with commercial insurance returned to the operating room (for a proble... Read more
You Be the Coder:
Same-day Billing for CRNA and Anesthesiologist
Question: Will insurers (including Medicare) pay for a certified registered nurse anesth... Read more
Available Years:  2001  2000  1999