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Anesthesia Coding Alert

CPT NEWS:
Updated CPT Codes Expand Your Spinal Surgery Options
Pain management specialists lose a little-used code You'll need to hit the ground runnin... Read more
DOCUMENTATION DISTINCTION:
Correctly Document TEE -- and Submit More Accurate Claims
Hint: Specific diagnoses and extra services can make a difference  Anesthesiologists... Read more
TEST YOURSELF:
See How Up-to-Speed You Are With TEE Coding
Check your knowledge against these scenarios With so many possibilities for reporting TEE ... Read more
CORRECTION:
TOS '09' Is Interventional PM Specialty Designation
The first-quarter 2006 issue of Pain Management Coding Alert article "Get Up to Speed With... Read more
READER QUESTION:
Sweat Through Unlisted Code for Hands and Feet
Question: Can we use new chemodenervation code 64653 for Botox injections to the patient's... Read more
READER QUESTION:
Multiple Fluoro Guidance Still Means 1 Code
Question: Our physician administered a caudal epidural injection, then a left sacroiliac (... Read more
READER QUESTION:
Verify Catheter Type Before Coding Removal
Question: Our physician inserted a catheter for pain relief. When the patient returned to ... Read more
READER QUESTION:
Know Levels to Take Your ROS Up a Notch
Question: What are the differences among the review of system (ROS) levels?   Ke... Read more
READER QUESTION:
Break Down Bilateral Botox Billing
Question: Can we bill chemodenervation codes 64612-64614 bilaterally? If so, which modifie... Read more
READER QUESTION:
Conduct Self-Audits Regularly
Question: Should our office perform self-audits regularly, or can we only perform one if w... Read more
YOU BE THE CODER:
Good Documentation Helps Multi-MD Claim
Question: Two of our anesthesiologists participated in a patient's multiple trauma case, i... Read more
Multiple Procedure Know-How Examine Anesthesia Choices for Mastectomy With Node Biopsy
Asking 2 big questions helps pinpoint the best code Your physician provides anesthesia... Read more
Pain Management Corner:
Don't Get Caught Groaning About Whiplash Treatment
Knowing how to submit claims correctly can ease your pain Coding for the diagnosis and tr... Read more
Diagnosis Checkpoint:
Steer Clear of Whiplash Stereotypes
Injuries can be serious, not just an insurance ploy For many people, the term "whiplash" c... Read more
NCCI Update:
Check Your Claims for New Injection Edits
Only a few changes in the latest National Correct Coding Initiative (NCCI) edits affect an... Read more
Reader Questions:
Divide Units for Some Botulinum Injections
Question: How do I determine the correct units for Botulinum codes J0585 and J0587? The ph... Read more
Reader Question:
X-Ray Gives Clues, but Talk to Physician
Question: We have a patient chart from an office visit that includes an x-ray of the patie... Read more
Reader Question:
Base Fee Includes Pre-Op Assessment
Question: Our CRNA meets with patients prior to surgery to ask about allergies or other he... Read more
Reader Question:
Identify Administration Type for Nerve Block
Question: What is the correct code for a diagnostic nerve block of the brachial plexus whe... Read more
Reader Question:
Discuss Auditory Test Codes With Carrier
Question: What CPT and ASA code should I use for a pediatric patient who is having an au... Read more
Reader Question:
Check Timing for Post-Op Astramorph
Question: The anesthesiologist wrote "spinal astramorph" on the charge sheet. How should I... Read more
Reader Question:
Post Hours to Justify 99050-99051 Claims
Question: What documentation do the special services after-hour codes require?  ... Read more
You Be the Coder:
Ruptured Biceps Tendon and Forearm
Question: What procedure and diagnosis codes should I submit for the repair of a patient's... Read more
ICD-9 Time:
Be Prepared for ICD-9 Changes--They're Just Around the Corner
New diagnoses give better pain management optionsAs the new ICD-9 codes kick in this month... Read more
Add-on Reminder:
Qualifying Circumstances Can Net You More Procedure Units
Don't forget add-on codes for non-Medicare carriersAs an experienced anesthesia coder, you... Read more
Quick Look:
Get Ready for ICD-9's Latest Changes
ICD-9 2007 incorporates more than 300 additions, revisions and deletionsYou'll have to get... Read more
Carrier Update:
Aetna Reviews Endo MAC Policy
Aetna is reviewing the medical necessity and appropriateness of MAC (monitored anesthesia ... Read more
READER QUESTIONS:
Think of Interscalene Block as Brachial Plexus
Question: What is the best CPT code for an inter-scalene nerve block? California S... Read more
READER QUESTIONS:
Separate Line Insertions From Critical Care
Question: Our anesthesiologist provided several services while performing a consultation w... Read more
READER QUESTIONS:
Submit 01965, 632 for Follow-up D&C
Question: A patient came in with fetal demise at 21 weeks. The anesthesiologist placed an ... Read more
READER QUESTIONS:
Verify Details for Synvisc Coding
Question: What diagnosis should I submit to support Synvisc administration?  Rhode Is... Read more
READER QUESTIONS:
Check 00300 for Abscess Procedure in Prone Position
Question: The surgeon performed an incision and drainage for a gluteal abscess while the p... Read more
YOU BE THE CODER:
Coding Prostate Brachytherapy
Question: How should I code anesthesia during brachytherapy of the prostate? Illinois Subs... Read more
Team Techniques:
There's More to Coding Retrobulbar Blocks Than Meets the Eye
Check these 3 areas before coding your next claim Performing eye surgery can be quick an... Read more
Pain Management Corner:
Know Your Levels to Code Post-Op Consults Correctly
Follow this guide to help assign the correct code The surgeon's global fee for procedure... Read more
Modifier Heads-Up:
There Are New Rules for Reporting Modifier 25: Here's What You Need to Know
CMS clarifies when -- and how -- to use it New guidelines regarding modifier 25 went ... Read more
Consult Checklist
Before you can code any type of consult, your physician must document the four R's of cons... Read more
Reader Questions:
Confirm Modifiers for 76005 in Surgical Facility
Question: What modifiers should I report with 76005 and 72275 in a surgical facility? Medi... Read more
Reader Questions:
Verify Details Before Coding Labial Repair
Question: Which surgical and anesthesia codes apply to labial repair (labial minora hypert... Read more
Reader Questions:
Clarify 'Periodic Monitoring' With Carrier
Question: How does Medicare define "periodic monitoring" on medical-direction cases?Connec... Read more
Reader Questions:
Remember 51 or 59 for Multilevel Injection
Question: Our physician administered a three-level lumbar injection for pain management. W... Read more
Reader Questions:
64470, 64472 Apply to Medial Branch Facet Block
Question: Our physician administered a facet block via the patient's medial branch nerves,... Read more
Reader Questions:
Tracheal Puncture Outweighs Esophagoscopy
Question: What should I report for an esophagoscopy and placement of a tracheal esophageal... Read more
You Be the Coder:
Physician Handoff During L&D
Question: Two of our anesthesiologists participated in a labor and delivery case. Dr. A ad... Read more
Carrier Update:
Smooth UHC Claims Processing by Staying In-the-Know About Revisions
3 anesthesia changes affect your everyday coding  A recent provider bulletin from Un... Read more
Pain Management Corner:
Recoup Transforaminal Payments With '1' Indicator
Follow these tips to make refiling bilateral claims easy Last fall, Medicare shocked code... Read more
Reimbursement Tips:
Find Success With Appeals, Not Sidetracked Claims
Keep these 6 steps in mind as you refile transforaminal claimsMedicare changed its stance ... Read more
Reader Questions:
Colon Procedure Code Depends on Technique
Question: What surgical and anesthesia codes apply to a colonoscopy with polypectomy?Oklah... Read more
Reader Questions:
Occipital Lipoma Excision = 00300
Question: How should I report anesthesia during excision of an occipital lipoma?Virginia S... Read more
Reader Questions:
Report Procedure, Not Anesthesia Mode
Question: Our physician administered a lumbar plexus block and sciatic nerve block as his ... Read more
Reader Questions:
Most Diagnostic, Therapeutic TEEs Are Billable
Question: Our physician often uses TEE (trans-esophageal echocardiography) during cardiac ... Read more
Reader Questions:
Get Below 20 C for Hypothermia
Question: Our anesthesiologists sometimes lower a patient's body temperature to 32 degrees... Read more
Reader Questions:
Check Crosswalk for Tubal Ligation
Question: How should I code for a hysteroscopic tubal ligation? Maryland Subscriber Answer... Read more
Reader Questions:
Report 64640 for RF of Ilioinguinal Neuroma
Question: How should I code radiofrequency of an ilioinguinal neuroma? Washington Subscrib... Read more
Reader Questions:
Intubation Coding Is Iffy
Question: The anesthesiologist left his case to assist another anesthesiologist with an in... Read more
Reader Questions:
Check With Physician on Chronic Pain Dx
Question: What is the best diagnosis code for chronic pain syndrome? Indiana Subscriber An... Read more
Reader Questions:
Reprogramming Is Key to Pump Coding
Question: What code should I report when my pain management specialist checks a patient's ... Read more
You Be the Coder:
Postprocedure Pain Consult
Question: A surgeon requested that our anesthesiologist evaluate a patient regarding posto... Read more
Technique Tips:
Round Out Your Ob Coding With Correct Duramorph Claims
Hint: It’s not your typical post-op management If your physicians enjoy using ... Read more
Modifier Know-How:
Treatment Rooms Can Offer Extra Cases for Modifier 23
Tip: Keep your eyes open for non-OR cases you should submit Treatment rooms have become co... Read more
Pain Management Corner:
Details Add Up When You're Coding Acute Pain Services
Check these 3 areas to be sure you're up to speed If your physicians routinely provide sho... Read more
Reader Questions:
Check Med Direction Guidelines for Post-Op Block
Question: Our anesthesiologist administered a patient's acute pain block for postoperative... Read more
Reader Questions:
VATS Code Hinges on 1-Lung Ventilation
Question: The patient's chart states, "VATS procedure with pleurodesis." What is VATS, and... Read more
Reader Questions:
Opt for Unlisted-Procedure Codes for Hardware Blocks
Question: We normally report 22899 instead of facet joint codes for hardware blocks. How s... Read more
Reader Questions:
Check Days Before Using 62263
Question: When should I report 62263 for pain management procedures?Illinois Subscriber An... Read more
Reader Questions:
64622 Can Be RF of Ramus Communicans (Maybe)
Question: Our physician has begun performing radiofrequency of the ramus communicans. Does... Read more
Reader Questions:
Submit 00320 for Laryngoscopy With Polypectomy
Question: What surgical and anesthesia codes apply to microscopic laryngoscopy with polype... Read more
You Be the Coder:
Clarify Incomplete Abortion With Carrier
Question: Medicaid denies our claims for incomplete abortion when we report anesthesia cod... Read more
Crosswalk Challenge:
Know When to Use Default Versus Alternative Anesthesia Codes
 Follow these 5 steps on difficult procedures The Anesthesia Crosswalk helps you... Read more
Check Yourself:
Ask Pointed Questions to Help Determine Codes
Correct claims can boil down to location and approachVerifying the procedure location and ... Read more
Pain Management Corner:
Play the Numbers for Correct Facet Joint Coding
Watch injection number and frequency: They're more important than you think You've selecte... Read more
Back to Basics:
Modifier 23 Can Help Ensure Payment for Non-OR Services
Tip: Catch extra procedures before they slip through the cracks If your physicians find t... Read more
Reader Questions:
Verify if Physician Used IVRA or MAC
Question: Several of our physicians refer to IVRA for various surgeries, particularly trig... Read more
Reader Questions:
Non-Epidural Sacrococcygeal Injection Is Tricky
Question: What code should I report when the physician administers a steroid injection in ... Read more
Reader Questions:
Don't Rely on 01996 for DepoDur Follow-Up
Question: How should I code a single dose of DepoDur following surgery and follow-up days?... Read more
Reader Questions:
Watch Timing, Location for Canceled Case
Question: A non-medically directed CRNA prepared to provide monitored anesthesia care duri... Read more
You Be the Coder:
TEE With Follow-Up Study
Question: Can the anesthesiologist bill for a TEE and complete Doppler study, then bill fo... Read more
NCCI Update:
Get Ready--Version 12.1 Edits Take Aim at CVC, Moderate Sedation
Good news:  There are exceptions that NCCI doesn't touchIf you routinely code for cen... Read more
Back to Basics:
Check Your Modifier 59 Use to Avoid Audit Hot Buttons
Focus on 2 areas to ensure correct reporting If your anesthesiologist performs multip... Read more
Pain Management Corner:
Use These 2 Starting-Point Strategies for Facet Injections
Verify the diagnosis and know the code range to head in the right directionIf your pain ma... Read more
READER QUESTIONS:
Stick With 1 Code for Temporary Tracheostomy
Question: Our physician administered anesthesia during a temporary tracheostomy. He also... Read more
READER QUESTIONS:
Multiple Procedures Mean Multiple Codes
Question: Our anesthesiologist administered general anesthesia during a bronchoscopy and m... Read more
READER QUESTIONS:
Special Circumstances Merit Better Choice Than 01967
Question: Most of our physicians report 01967 for vaginal deliveries. What is the differen... Read more
READER QUESTIONS:
Unusual Positions Mean Extra Units--Sometimes
Question: The surgeon placed the patient in the left lateral position for surgery on the r... Read more
READER QUESTIONS:
General Code May Be Only Option for Central Pain Syndrome Diagnosis
Question: What diagnosis applies to central pain syndrome? Arkansas Subscriber Answer... Read more
You Be the Coder:
Deciding Between 00560, 00563 for Hypothermia
Question: Our physician provided anesthesia during a patient’s mitral valve repair... Read more
Compliant Coding:
Monitor 3 Trap-Prone Areas to Stop Upcoding Errors in Their Tracks
Check your base units to avoid audit troublesEven if upcoding claims (miscoding procedures... Read more
Coding Checkpoint:
Quick Tips to Avoid Upcoding Errors
Reading descriptor details helps keep claims cleanYou can take steps to help reduce the up... Read more
CPT Update:
AMA Releases Updates to 2006 Codes
Change your parenthetical notes for 01991-01995The AMA recently published CPT 2006 Errata,... Read more
Pain Management Corner:
J Codes Are Your Key When Coding Botulinum
Check billing units and vials before submitting claimsIf your pain management provider pur... Read more
READER QUESTIONS:
You Can Code PCEA Initiation and Follow-Up
Question: How should I code PCEA initiation for a commercial carrier? Can I code additiona... Read more
READER QUESTIONS:
Consider 01922 or 00120 for Auditory Test
Question: Our physician administered general anesthesia while a 16-month-old child underwe... Read more
READER QUESTIONS:
Watch Documentation Before Coding Consult
Question: Our anesthesiologist noted he performed a postoperative pain consultation and in... Read more
READER QUESTIONS:
Report 00940 for Episiotomy Repair
Question: How should I code an episiotomy repair done under general anesthesia after the w... Read more
READER QUESTIONS:
Don't Forget 3-Year Rule for New Consults
Question: A physician in another practice asked our pain specialist to perform a patient c... Read more
READER QUESTIONS:
Only Report CP Block for Post-Op Pain
Question: Our physician used general anesthesia during a patient's carotid endarterectomy,... Read more
READER QUESTIONS:
00860 Is Better Code for TVT Surgery
Question: What anesthesia code should I use for TVT (transvaginal taping) surgery? Some ph... Read more
You Be the Coder:
Know When to Bill Multiple A-Lines
Question: Can we bill for two arterial (A-line) insertions during the same surgery? Texas ... Read more
Extra Service Evaluation:
You Can Get Paid for Wake-up Tests -- Sometimes
Procedure details determine if you can report them separately Remembering a little-used m... Read more
Definition Corner:
What Is a Wake-up Test?
A wake-up test detects any malfunction in the patient's spinal cord during surgery. The an... Read more
Medication Watchpoint:
Check High-Risk Meds to Help Your Nonstandard Claims
Long-term use can help justify MAC Details about a patient's medication history -- speci... Read more
Reimbursement Update:
Medicare Fees Will Remain at 2005 Amounts
Congress passes bill keeping conversion factor the sameCoders in every specialty received ... Read more
Therapy Focus:
Botulinum Coding Is More Than Skin Deep
Botox helps relieve pain for many patients Pain management coders know that botulinum to... Read more
TOS Tip:
Get Up to Speed With Ins and Outs of Specialty Designations
Report the right service so claims fly through correctly Whether your physicians focus on... Read more
Reader Questions:
Single Diagnosis Usually Fills the Bill
Question: How do I determine the correct diagnosis codes for billing anesthesia? Should I ... Read more
Reader Questions:
Subsequent Code Applies to No-Go Surgery
Question: Our anesthesiologist performed a patient's presurgical assessment, but the surge... Read more
Reader Questions:
Verify Emergency Care Before Filing as Such
Question: I-m doing some fill-in coding for an anesthesiologist who writes an -E- beside e... Read more
Reader Questions:
EKG Readings Can Be Legitimate Charges
Question: The surgeon ordered a patient's EKG at our outpatient facility, and the anesthes... Read more
Reader Questions:
2-Day Cases Might Need 2-Line Claims
Question: How should I report multiple line items for an anesthesia case that spans two da... Read more
Reader Questions:
Add 99100 for Infant's Lymphatic Excision
Question: How should I report anesthesia for -excision of a cervical cystic hygroma -- l... Read more
Reader Questions:
Check Carrier Preference on Single-Shot Lumbar Block
Question: Our anesthesiologist administered a single-shot lumbar plexus block for postoper... Read more
Reader Questions:
Muscle Count Is Key to TPI Coding
Question: How should I report bilateral trigger point injections in three locations for a ... Read more
Reader Questions:
Remember 59 With Post-Op Caudal Block
Question: What CPT code applies to a caudal block for postoperative pain management? ... Read more
Reader Questions:
Epidurals Aren't Just for Labor Patients
Question: When should I use epidural codes 62310-62319? Do they only apply to postoperativ... Read more
Reader Questions:
Multiple Injections Don't Always Mean Modifiers
Question: What modifiers should I report for a visit that includes a right shoulder inject... Read more
Reader Questions:
Document Digits for Tendon Injections
Question: How should I code tendon injections to both of the patient's thumbs and both thi... Read more
Reader Questions:
64449 Is Best for Psoas Compartment Block
Question: How should I code a psoas compartment block?Nevada Subscriber Answer: Report a ... Read more
You Be the Coder:
Know When to Bill Intubations
Question: Our anesthesiologist dictated a separate operative note during a procedure sta... Read more
You Be the Coder:
Pulsed RF With Dorsal Root, Nerve Blocks
Question: Our physician performed multi-level lumbar dorsal root ganglion and selected ner... Read more
Edits Update:
NCCI 12.0 Says New Abortion Codes Include All Related Services
Have no fear:  Most anesthesia changes should be common-sense edits to youIf you need... Read more
Pain Management Corner:
NCCI Edits Take on Vertebroplasty, Kyphoplasty Procedures
Tip:  Watch pairings with new hydration codes. If you code for pain management s... Read more
Locum Know-How:
Don't Get Left in the Lurch With CRNAs and Locum Issues
Avoid the trap of reporting services with modifier Q6 One of your anesthesiologists t... Read more
Quick Checkpoint:
Meet All Criteria Before Reporting Locum Services
Modifier Q6 doesn't apply to contract workersIf you-re coding for a physician in a locum t... Read more
READER QUESTIONS:
All TTE Procedures Lead to 01922
Question: What anesthesia code applies to transthoracic echocardiography (TTE) on a smal... Read more
READER QUESTIONS:
01320 Is Best Bet for Thompson Procedure
Question: How should I report a Thompson procedure performed for a bilateral dermatic flap... Read more
READER QUESTIONS:
Try GY or GZ for Special Circumstances Claims
Question: I know Medicare Part B does not reimburse for extenuating circumstances, but som... Read more
READER QUESTIONS:
00880, 00882 Might Work for VC Filter Removal
Question: What CPT and anesthesia codes apply to removal of a vena cava filter? Tennessee ... Read more
READER QUESTIONS:
Rely on Multiple Diagnoses to Justify P Status
Question: Where should I find supporting documentation for a P3 patient? Can I use informa... Read more
READER QUESTIONS:
Watch Documentation With In-Office Vertebroplasty
Question: One of our physicians performed a vertebroplasty in the office while another pro... Read more
READER QUESTIONS:
Split Claim for Involvement in Labor Case
Question: A medically directed CRNA administered anesthesia for a labor patient, and the a... Read more
You Be the Coder:
All Occipital Nerve Blocks Aren't the Same
Question: I was told to report the same code for either greater or lesser occipital nerve ... Read more
Documentation Checkpoint:
Determine if 1 Sentence Counts as a 'Formal Radiologic Report'
Hint:  Maybe or maybe not, depending on the information providers giveWhen you-re rep... Read more
Guideline Help:
ACR Lists Components of Formal Reports
Documentation would get an 'A,' but doctors might not go for itIf your group is struggling... Read more
2006 Hot Button:
Take Note of E/M Changes Before Coding Your Next Consult
Confirmatory and follow-up inpatient options are goneIf you find yourself periodically cod... Read more
News Brief:
2006 CF Could Damage Anesthesia, PM Bottom Lines
Report the corrent CF depending on your serviceWhether your group focuses on anesthesia or... Read more
2006 Update:
CPT Introduces New Codes for Abortion Anesthesia
Understand the differences between 2 reporting optionsCPT 2006 incorporates only two new c... Read more
READER QUESTIONS:
Extent of Pectoralis Repair Dictates Code
Question: What anesthesia code should I use for pectoralis repair?Massachusetts Subscriber... Read more
READER QUESTIONS:
Rely on Multiple Codes for Labor Turned C-Section
Question: Our anesthesiologist placed a continuous epidural for a labor patient, and then ... Read more
READER QUESTIONS:
Base Debridement Code on Procedure Depth
Question: Our physician administered anesthesia during a debridement excision of toes; the... Read more
READER QUESTIONS:
01922 Is Best Bet for Adrenal Gland Biopsy
Question: How should I code for anesthesia during a CT-guided adrenal gland biopsy? Washin... Read more
READER QUESTIONS:
Airway Loss Is Key to MAC Versus General
Question: What guideline should I follow when determining whether to code a case using pro... Read more
READER QUESTIONS:
Watch Timing for Delivery and Sterilization Coding
Question: Our carrier is denying claims when the obstetrician performs a sterilization the... Read more
You Be the Coder:
Choosing a Code for Auditory Test Anesthesia
Question: Our physician provided anesthesia while an 11-month-old patient underwent an aud... Read more
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