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Anesthesia Coding Alert - 2006; Volume 8, Number 12
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...
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DOCUMENTATION DISTINCTION:
Correctly Document TEE -- and Submit More Accurate Claims
Hint: Specific diagnoses and extra services can make a difference Anesthesiologists...
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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 ...
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CORRECTION:
TOS '09' Is Interventional PM Specialty Designation
The first-quarter 2006 issue of Pain Management Coding Alert article "Get Up to Speed With...
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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...
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READER QUESTION:
Multiple Fluoro Guidance Still Means 1 Code
Question: Our physician administered a caudal epidural injection, then a left sacroiliac (...
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READER QUESTION:
Verify Catheter Type Before Coding Removal
Question: Our physician inserted a catheter for pain relief. When the patient returned to ...
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READER QUESTION:
Know Levels to Take Your ROS Up a Notch
Question: What are the differences among the review of system (ROS) levels? Ke...
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READER QUESTION:
Break Down Bilateral Botox Billing
Question: Can we bill chemodenervation codes 64612-64614 bilaterally? If so, which modifie...
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READER QUESTION:
Conduct Self-Audits Regularly
Question: Should our office perform self-audits regularly, or can we only perform one if w...
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YOU BE THE CODER:
Good Documentation Helps Multi-MD Claim
Question: Two of our anesthesiologists participated in a patient's multiple trauma case, i...
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Anesthesia Coding Alert - 2006; Volume 8, Number 11
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...
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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...
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Diagnosis Checkpoint:
Steer Clear of Whiplash Stereotypes
Injuries can be serious, not just an insurance ploy For many people, the term "whiplash" c...
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NCCI Update:
Check Your Claims for New Injection Edits
Only a few changes in the latest National Correct Coding Initiative (NCCI) edits affect an...
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Reader Questions:
Divide Units for Some Botulinum Injections
Question: How do I determine the correct units for Botulinum codes J0585 and J0587? The ph...
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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...
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Reader Question:
Base Fee Includes Pre-Op Assessment
Question: Our CRNA meets with patients prior to surgery to ask about allergies or other he...
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Reader Question:
Identify Administration Type for Nerve Block
Question: What is the correct code for a diagnostic nerve block of the brachial plexus whe...
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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...
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Reader Question:
Check Timing for Post-Op Astramorph
Question: The anesthesiologist wrote "spinal astramorph" on the charge sheet. How should I...
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Reader Question:
Post Hours to Justify 99050-99051 Claims
Question: What documentation do the special services after-hour codes require? ...
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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...
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Anesthesia Coding Alert - 2006; Volume 8, Number 10
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...
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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...
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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...
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Carrier Update:
Aetna Reviews Endo MAC Policy
Aetna is reviewing the medical necessity and appropriateness of MAC (monitored anesthesia ...
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READER QUESTIONS:
Think of Interscalene Block as Brachial Plexus
Question: What is the best CPT code for an inter-scalene nerve block? California S...
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READER QUESTIONS:
Separate Line Insertions From Critical Care
Question: Our anesthesiologist provided several services while performing a consultation w...
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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 ...
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READER QUESTIONS:
Verify Details for Synvisc Coding
Question: What diagnosis should I submit to support Synvisc administration? Rhode Is...
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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...
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YOU BE THE CODER:
Coding Prostate Brachytherapy
Question: How should I code anesthesia during brachytherapy of the prostate? Illinois Subs...
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Anesthesia Coding Alert - 2006; Volume 8, Number 9
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...
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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...
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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 ...
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Consult Checklist
Before you can code any type of consult, your physician must document the four R's of cons...
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Reader Questions:
Confirm Modifiers for 76005 in Surgical Facility
Question: What modifiers should I report with 76005 and 72275 in a surgical facility? Medi...
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Reader Questions:
Verify Details Before Coding Labial Repair
Question: Which surgical and anesthesia codes apply to labial repair (labial minora hypert...
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Reader Questions:
Clarify 'Periodic Monitoring' With Carrier
Question: How does Medicare define "periodic monitoring" on medical-direction cases?Connec...
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Reader Questions:
Remember 51 or 59 for Multilevel Injection
Question: Our physician administered a three-level lumbar injection for pain management. W...
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Reader Questions:
64470, 64472 Apply to Medial Branch Facet Block
Question: Our physician administered a facet block via the patient's medial branch nerves,...
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Reader Questions:
Tracheal Puncture Outweighs Esophagoscopy
Question: What should I report for an esophagoscopy and placement of a tracheal esophageal...
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You Be the Coder:
Physician Handoff During L&D
Question: Two of our anesthesiologists participated in a labor and delivery case. Dr. A ad...
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Anesthesia Coding Alert - 2006; Volume 8, Number 8
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...
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Pain Management Corner:
Recoup Transforaminal Payments With '1' Indicator
Follow these tips to make refiling bilateral claims easy Last fall, Medicare shocked code...
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Reimbursement Tips:
Find Success With Appeals, Not Sidetracked Claims
Keep these 6 steps in mind as you refile transforaminal claimsMedicare changed its stance ...
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Reader Questions:
Colon Procedure Code Depends on Technique
Question: What surgical and anesthesia codes apply to a colonoscopy with polypectomy?Oklah...
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Reader Questions:
Occipital Lipoma Excision = 00300
Question: How should I report anesthesia during excision of an occipital lipoma?Virginia S...
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Reader Questions:
Report Procedure, Not Anesthesia Mode
Question: Our physician administered a lumbar plexus block and sciatic nerve block as his ...
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Reader Questions:
Most Diagnostic, Therapeutic TEEs Are Billable
Question: Our physician often uses TEE (trans-esophageal echocardiography) during cardiac ...
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Reader Questions:
Get Below 20 C for Hypothermia
Question: Our anesthesiologists sometimes lower a patient's body temperature to 32 degrees...
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Reader Questions:
Check Crosswalk for Tubal Ligation
Question: How should I code for a hysteroscopic tubal ligation? Maryland Subscriber Answer...
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Reader Questions:
Report 64640 for RF of Ilioinguinal Neuroma
Question: How should I code radiofrequency of an ilioinguinal neuroma? Washington Subscrib...
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Reader Questions:
Intubation Coding Is Iffy
Question: The anesthesiologist left his case to assist another anesthesiologist with an in...
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Reader Questions:
Check With Physician on Chronic Pain Dx
Question: What is the best diagnosis code for chronic pain syndrome? Indiana Subscriber An...
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Reader Questions:
Reprogramming Is Key to Pump Coding
Question: What code should I report when my pain management specialist checks a patient's ...
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You Be the Coder:
Postprocedure Pain Consult
Question: A surgeon requested that our anesthesiologist evaluate a patient regarding posto...
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Anesthesia Coding Alert - 2006; Volume 8, Number 7
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 ...
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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...
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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...
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Reader Questions:
Check Med Direction Guidelines for Post-Op Block
Question: Our anesthesiologist administered a patient's acute pain block for postoperative...
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Reader Questions:
VATS Code Hinges on 1-Lung Ventilation
Question: The patient's chart states, "VATS procedure with pleurodesis." What is VATS, and...
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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...
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Reader Questions:
Check Days Before Using 62263
Question: When should I report 62263 for pain management procedures?Illinois Subscriber An...
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Reader Questions:
64622 Can Be RF of Ramus Communicans (Maybe)
Question: Our physician has begun performing radiofrequency of the ramus communicans. Does...
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Reader Questions:
Submit 00320 for Laryngoscopy With Polypectomy
Question: What surgical and anesthesia codes apply to microscopic laryngoscopy with polype...
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You Be the Coder:
Clarify Incomplete Abortion With Carrier
Question: Medicaid denies our claims for incomplete abortion when we report anesthesia cod...
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Anesthesia Coding Alert - 2006; Volume 8, Number 6
Crosswalk Challenge:
Know When to Use Default Versus Alternative Anesthesia Codes
Follow these 5 steps on difficult procedures The Anesthesia Crosswalk helps you...
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Check Yourself:
Ask Pointed Questions to Help Determine Codes
Correct claims can boil down to location and approachVerifying the procedure location and ...
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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...
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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...
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Reader Questions:
Verify if Physician Used IVRA or MAC
Question: Several of our physicians refer to IVRA for various surgeries, particularly trig...
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Reader Questions:
Non-Epidural Sacrococcygeal Injection Is Tricky
Question: What code should I report when the physician administers a steroid injection in ...
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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?...
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Reader Questions:
Watch Timing, Location for Canceled Case
Question: A non-medically directed CRNA prepared to provide monitored anesthesia care duri...
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You Be the Coder:
TEE With Follow-Up Study
Question: Can the anesthesiologist bill for a TEE and complete Doppler study, then bill fo...
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Anesthesia Coding Alert - 2006; Volume 8, Number 5
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...
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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...
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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...
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READER QUESTIONS:
Stick With 1 Code for Temporary Tracheostomy
Question: Our physician administered anesthesia during a temporary tracheostomy. He also...
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READER QUESTIONS:
Multiple Procedures Mean Multiple Codes
Question: Our anesthesiologist administered general anesthesia during a bronchoscopy and m...
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READER QUESTIONS:
Special Circumstances Merit Better Choice Than 01967
Question: Most of our physicians report 01967 for vaginal deliveries. What is the differen...
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READER QUESTIONS:
Unusual Positions Mean Extra Units--Sometimes
Question: The surgeon placed the patient in the left lateral position for surgery on the r...
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READER QUESTIONS:
General Code May Be Only Option for Central Pain Syndrome Diagnosis
Question: What diagnosis applies to central pain syndrome? Arkansas Subscriber Answer...
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You Be the Coder:
Deciding Between 00560, 00563 for Hypothermia
Question: Our physician provided anesthesia during a patient’s mitral valve repair...
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Anesthesia Coding Alert - 2006; Volume 8, Number 4
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...
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Coding Checkpoint:
Quick Tips to Avoid Upcoding Errors
Reading descriptor details helps keep claims cleanYou can take steps to help reduce the up...
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CPT Update:
AMA Releases Updates to 2006 Codes
Change your parenthetical notes for 01991-01995The AMA recently published CPT 2006 Errata,...
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Pain Management Corner:
J Codes Are Your Key When Coding Botulinum
Check billing units and vials before submitting claimsIf your pain management provider pur...
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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...
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READER QUESTIONS:
Consider 01922 or 00120 for Auditory Test
Question: Our physician administered general anesthesia while a 16-month-old child underwe...
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READER QUESTIONS:
Watch Documentation Before Coding Consult
Question: Our anesthesiologist noted he performed a postoperative pain consultation and in...
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READER QUESTIONS:
Report 00940 for Episiotomy Repair
Question: How should I code an episiotomy repair done under general anesthesia after the w...
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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...
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READER QUESTIONS:
Only Report CP Block for Post-Op Pain
Question: Our physician used general anesthesia during a patient's carotid endarterectomy,...
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READER QUESTIONS:
00860 Is Better Code for TVT Surgery
Question: What anesthesia code should I use for TVT (transvaginal taping) surgery? Some ph...
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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 ...
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Anesthesia Coding Alert - 2006; Volume 8, Number 3
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...
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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...
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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...
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Reimbursement Update:
Medicare Fees Will Remain at 2005 Amounts
Congress passes bill keeping conversion factor the sameCoders in every specialty received ...
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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 ...
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Reader Questions:
Subsequent Code Applies to No-Go Surgery
Question: Our anesthesiologist performed a patient's presurgical assessment, but the surge...
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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...
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Reader Questions:
EKG Readings Can Be Legitimate Charges
Question: The surgeon ordered a patient's EKG at our outpatient facility, and the anesthes...
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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...
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Reader Questions:
Add 99100 for Infant's Lymphatic Excision
Question: How should I report anesthesia for -excision of a cervical cystic hygroma -- l...
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Reader Questions:
Check Carrier Preference on Single-Shot Lumbar Block
Question: Our anesthesiologist administered a single-shot lumbar plexus block for postoper...
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Reader Questions:
Muscle Count Is Key to TPI Coding
Question: How should I report bilateral trigger point injections in three locations for a ...
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Reader Questions:
Remember 59 With Post-Op Caudal Block
Question: What CPT code applies to a caudal block for postoperative pain management? ...
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Reader Questions:
Epidurals Aren't Just for Labor Patients
Question: When should I use epidural codes 62310-62319? Do they only apply to postoperativ...
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Reader Questions:
Multiple Injections Don't Always Mean Modifiers
Question: What modifiers should I report for a visit that includes a right shoulder inject...
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Reader Questions:
Document Digits for Tendon Injections
Question: How should I code tendon injections to both of the patient's thumbs and both thi...
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Reader Questions:
64449 Is Best for Psoas Compartment Block
Question: How should I code a psoas compartment block?Nevada Subscriber Answer: Report a ...
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You Be the Coder:
Know When to Bill Intubations
Question: Our anesthesiologist dictated a separate operative note during a procedure sta...
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You Be the Coder:
Pulsed RF With Dorsal Root, Nerve Blocks
Question: Our physician performed multi-level lumbar dorsal root ganglion and selected ner...
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Anesthesia Coding Alert - 2006; Volume 8, Number 2
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...
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Pain Management Corner:
NCCI Edits Take on Vertebroplasty, Kyphoplasty Procedures
Tip: Watch pairings with new hydration codes. If you code for pain management s...
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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...
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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...
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READER QUESTIONS:
All TTE Procedures Lead to 01922
Question: What anesthesia code applies to transthoracic echocardiography (TTE) on a smal...
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READER QUESTIONS:
01320 Is Best Bet for Thompson Procedure
Question: How should I report a Thompson procedure performed for a bilateral dermatic flap...
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READER QUESTIONS:
Try GY or GZ for Special Circumstances Claims
Question: I know Medicare Part B does not reimburse for extenuating circumstances, but som...
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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 ...
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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...
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READER QUESTIONS:
Split Claim for Involvement in Labor Case
Question: A medically directed CRNA administered anesthesia for a labor patient, and the a...
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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 ...
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Anesthesia Coding Alert - 2006; Volume 8, Number 1
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...
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Guideline Help:
ACR Lists Components of Formal Reports
Documentation would get an 'A,' but doctors might not go for itIf your group is struggling...
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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...
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READER QUESTIONS:
Rely on Multiple Codes for Labor Turned C-Section
Question: Our anesthesiologist placed a continuous epidural for a labor patient, and then ...
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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...
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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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