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Newsletter
Anesthesia Coding Alert
Anesthesia Coding Alert
Anesthesia Coding Alert - 2017; Volume 19, Number 12
Coding Refresher:
Check Out This Primer for Successfully Coding Standby Anesthesia
Hint: Availability means more than hands-on care. It's not unusual for an anesthesiologis...
Read more
Compliance:
Don't Get Lost in the Medicare Card Number Confusion
Transition is difficult, but will be more HIPAA friendly. As confusion continues to ebb a...
Read more
Case Study:
Manage Your Updates Accordingly to Close the Door on Hacker
You invite cyber threats in by mismanaging security and technology. These days the slight...
Read more
Reader Question:
Situation Details Show How to Code Multiple Services on Same DOS
Question: We have two claims for the same patient on the same date of service, but two dif...
Read more
Reader Question:
Code Only C-section, Not Additional Tubal Ligation
Question: I am new to anesthesia coding and need to know how to code when a patient has a ...
Read more
Reader Question:
Watch the Time for CRNAs Awaiting Medicare Enrollment
Question: We bill for the service of the CRNAs who work in our clinic. How should we bill ...
Read more
Reader Question:
Submit 00910 for Anesthesia During Urolift
Question: What is the correct anesthesia CPT® code for a Urolift procedure? Minnesota Su...
Read more
Reader Question:
Rely on +76937 for U/S Guidance for Many Line Placements
Question: Is there a code that can go with 36620 for ultrasound guidance? Some doctors are...
Read more
You Be the Coder:
How Self-pay Status Can Change the Need for a Claim
Question: I have a cosmetic case that cancelled after the pre-op exam but before induction...
Read more
Anesthesia Coding Alert - 2017; Volume 19, Number 11
2018 Coding:
Prepare Now for Anesthesia's 2018 CPT® Updates
Don't miss these new additions – and deletions. With new CPT® changes becoming effecti...
Read more
Pain Management Focus:
Verify Unilateral vs. Bilateral on Chemodenervation Claims
The payer might be looking for modifier 50. If you report pain management services on occ...
Read more
Compliance:
Understand What Points to a Privacy Violation
Know the exceptions that don't get reported to HHS. Before you can start identifying pote...
Read more
Reader Question:
Study Surgical Notes for Best Pre-eclampsia Diagnosis
Question: What is the best ICD-10 code for an abdominal hemorrhage during a repeat C-...
Read more
Reader Question:
Remember Modifiers for CRNA Pre-op Eval and Anesthesia
Question: The CRNA provided a patient's pre-op evaluation and ocular anesthetic, then...
Read more
Reader Question:
Code 93503 Without Additional Line, In Most Cases
Question: I have an anesthesia provider asking me about this scenario: someone places...
Read more
Reader Question:
Cardiopulmonary Monitoring Is Included in Procedure Code
Question: Our anesthesiologist used blood pressure monitoring, pulse oximetry, and ra...
Read more
Reader Question:
Verify the Reason Before Filing 62273
Question: How do I code an epidural blood patch procedure on the same day as labor an...
Read more
Reader Question:
Include Modifier 59 for Return to Surgery
Question: Our anesthesiologist provided general anesthesia during a morning surgery. ...
Read more
Reader Question:
Accurate Migraine Coding Depends on Terminology Details
Question: Notes indicate that the clinician performed a bilateral Botox A (onabotulin...
Read more
You Be the Coder:
Code Correctly for Subclavian Vein Line Placement
Question: One of our physicians is asking about the correct code for placement of a c...
Read more
Anesthesia Coding Alert - 2017; Volume 19, Number 10
Modifier Usage:
Use Higher-level P Modifiers to Support Your Provider's Work in Special Cases
One of the first things anesthesia coders learn is the importance of including physical st...
Read more
ICD-10:
Follow These Tips to Clear Up COPD Diagnosis Coding
The use of anesthesia carries a lot of risk and can affect the patient's outcome, says Lau...
Read more
CPT® 2018:
Prepare for More Changes to Telehealth Coding
With the rise and necessity of telehealth, CMS pushes forward, adding more coding choices ...
Read more
Reader Question:
Coding Correctly for Canceled Surgery
Question: The anesthesiologist spent 20 minutes with a patient and provided Fentanyl,...
Read more
Reader Question:
Submit Same Modifiers for CRNA and AA
Question: Are anesthesia assistants the same as a CRNA in regard to billing? For exam...
Read more
Reader Question:
Watch Line Usage Before Billing CVP With Swan-Ganz
Question: How would we bill for placement of a central line and Swan-Ganz catheter fo...
Read more
Reader Question:
Check the Details Before Submitting Separate Anesthesia for 27096
Question: We had a physician bill CPT® 27096 and a CRNA bill 01992 with a QZ modifie...
Read more
Reader Question:
Here's the Lowdown on Coding Occipital Nerve Blocks
Question: Our pain management physician performed three bilateral nerve blocks: a les...
Read more
You Be the Coder:
Get Familiar With Moderate Sedation Choices
Question: I'm trying to code anesthesia for a urethrocystoscopy for fulguration of a ...
Read more
Anesthesia Coding Alert - 2017; Volume 19, Number 9
L&D Coding:
Get Solid Answers to 4 Top Questions About C-section Anesthesia
Remember, no two deliveries – or coding for them – are ever exactly the same. ...
Read more
Compliance:
Look Toward Possible MIPS Changes in 2018
Being in the transition years can still play in your favor. CMS recently released propose...
Read more
Reader Question:
Verify That the Service Provided Constitutes Anesthesia Time
Question: What are the minimum documentation requirements in order to be compliant wi...
Read more
Reader Question:
Don't Try to Submit Standard E/M Code for Anesthesia Consult
Question: I have recently had some discussion with our office administrator about why...
Read more
Reader Question:
Get Clear Documentation of Age for Reporting +99100
Question: What guidelines should I follow when reporting +99100 for a patient of extr...
Read more
Reader Question:
Choose 00470 Over 00550 for Sternal Wire Removal
Question: I could use some help coming up with an anesthesia code for this service. T...
Read more
Reader Question:
Pay Attention to Difference Between 00567 and 00568
Question: Would you please help me clarify what ASA should be used for a CABG procedu...
Read more
Reader Question:
Incorporate Technology, But Don't Disconnect With Patients
Question: We’re starting to use more technology and online tools to engage our ...
Read more
Reader Question:
Hiring New Staff? Don't Ask These Interview Questions
Question: Our practice is growing, and my practice manager has asked me to help by co...
Read more
Reader Question:
Remember There's No Need for 77003 With Epidural Injections
Question: How can we report fluoroscopic guidance with epidural injections in 2017? I...
Read more
You Be the Coder:
Choose Wisely Between 00910 and 00912
Question: I’m trying to code anesthesia for a urethrocystoscopy for fulguration...
Read more
Anesthesia Coding Alert - 2017; Volume 19, Number 8
ICD-10:
These Proposed Changes to ICD-10 Could Affect Your Anesthesia Coding
Keep your providers abreast of details that help avoid denials. As an anesthesia coder, y...
Read more
Pain Management Focus:
Follow This Advice to Keep From Botching Your Botox A Claims
Location is everything when selecting some related codes. When you think of Botox, you mi...
Read more
Reader Question:
Here's How to Share Time Between CRNAs
Question: We sometimes use just CRNAs during surgery and report their service with a ...
Read more
Reader Question:
Be Careful of Billing +76937 With Other Procedures
Question: We are billing ultrasound guidance as +76937 x 2 when performing two proced...
Read more
Reader Question:
Let Insurer Divide the Fees Between MD and CRNA
Question: Can you help me understand how insurance companies process a 50/50 split wh...
Read more
Reader Question:
Follow Payer Guidelines for Reporting Bilateral Femoral Nerve Block
Question: Our anesthesiologist was present during a bilateral knee replacement surger...
Read more
You Be the Coder:
Understand the Service Each TEE Code Represents
Question: I was asked today about TEE coding by someone who stated that there is diff...
Read more
Anesthesia Coding Alert - 2017; Volume 19, Number 7
Procedure Focus:
Follow 4 Steps to Find Success With Endoscopic GI Procedures
Hint: Get clear documentation supporting medical necessity to boost your chances. Whether...
Read more
Billing:
Ease Your Patients' Concerns About Paying Electronically
These 9 tips will help smooth the transition. Electronic transactions – including p...
Read more
Correction:
Calculate Burn Code by Area Treated, Not Total Burns
Focus on area, then do the math. In the March 2017 issue of Anesthesia Coding Alert (...
Read more
Reader Question:
Follow These Basics for Knowing Whether Q6 Applies
Question: Our group is starting to use quite a few locums for coverage in special cir...
Read more
Reader Question:
Report 01961 for PCA to C-section Anesthesia
Question: I’m coding for a case in which a patient was not a candidate for a la...
Read more
Reader Question:
Look to 01991 for Anesthesia During Genicular Ablation
Question: A CRNA in our practice provides MAC (monitored anesthesia care) for pain ma...
Read more
Reader Question:
Preauthorization for 62322 Won't Cover a Shift to 64483
Question: My physician requested approval for 62322, but actually performed the servi...
Read more
Reader Question:
Start With S13 Family for Neck Sprain Diagnosis
Question: Our pain management provider recently provided an evaluation and management...
Read more
You Be the Coder:
Get a Refresher on Medicare's Reimbursement Formula
Question: I’m new to coding and am trying to see if our Medicare reimbursement ...
Read more
Anesthesia Coding Alert - 2017; Volume 19, Number 6
Procedure Focus:
Nail Down Your Anesthesiologist's Service Before Coding for TEE
Not all code options apply to every provider. Transesophageal echocardiography (TEE) is a...
Read more
Compliance:
Keep TEEs on Track With Documentation Templates
Help your physicians share the info coders need. TEE provides specialized information abo...
Read more
Practice Management:
Follow These 7 Steps Before Panicking Over an Audit Letter
Your practice has received that dreaded notification: a Medicare audit letter. Whether it&...
Read more
Reader Question:
Get Clear on What Each Component of Reimbursement Represents
Question: We've gotten a kick-back claim where we reported 01480 with 15 units; the i...
Read more
Reader Question:
Turn to O45 Family for Placenta Abruptio Choices
Question: I bill for obstetrics anesthesia: Our provider placed an epidural for deliv...
Read more
Reader Question:
Communicate With Insurer When "IC" Applies
Question: One of our anesthesiologists insists there is an ASA code valued at 1 base ...
Read more
Reader Question:
Don't Forget You Can Code Therapeutic Drugs With TPIs
Question: Our pain management specialist completed a significant, separately identifi...
Read more
Reader Question:
Consider Your Choices for Meeting the Timely Filing Deadline
Question: Our pain management specialist performed a service for a patient despite th...
Read more
You Be the Coder:
Know Which Modifiers to List First on Your Claim
Question: We keep getting an edit stating that the "33" and "PT" modifiers are not co...
Read more
Anesthesia Coding Alert - 2017; Volume 19, Number 5
L&D Anesthesia:
Let Lessons From 3 Situations Keep Your L&D Coding Under Control
Pay special attention to the 'permissible sins.' Coding for obstetrical anesthesia can ge...
Read more
L&D Anesthesia:
Know These Key Terms When Coding Labor Anesthesia
Brushing up on vocabulary can help you understand what was done. Getting familiar with ce...
Read more
Pain Management Focus:
Are You Covering All the Details for Chemodenervation Claims?
Pinpointing body area and laterality are keys to your success. If any of your anesthesiol...
Read more
ICD-10:
Don't Overlook Secondary Diagnoses Such as Gestational Diabetes
You might be able to bump up P code assignment as well. When coding for anesthesia during...
Read more
Reader Question:
Don't Worry About Ending Times for Line Placement
Question: Does the end time need to be documented for 36620? Or does the anesthesia p...
Read more
Reader Question:
Crosswalk the Urologist's Code to Choose Between 00910 and 00912
Question: I’m trying to code anesthesia for a urethrocystoscopy for fulguration...
Read more
Reader Question:
Combine Times for Two Surgeons During a Single Encounter
Question: I heard that when a surgery is performed by two surgeons that you can bill ...
Read more
Reader Question:
Knee and Shoulder Blocks Should Both Be Payable
Question: A patient had rotator cuff repair and knee arthroscopies done during the sa...
Read more
You Be the Coder:
Medically Directed CRNA During Retrobulbar Blocks
Question: When our patients have cataract procedures, the anesthesiologist administer...
Read more
Anesthesia Coding Alert - 2017; Volume 19, Number 4
Procedure Coding:
Think Like a Surgery Coder When Reporting Burn Care
Anatomic site is paramount to your selection. Coding for burn care can get tricky from an...
Read more
ICD-10:
Follow These 5 Tips to the Best Burn Diagnosis
Hint: You'll probably need an 'X' placeholder. Now that you've brushed up on how to corre...
Read more
Compliance:
Don't Let Misunderstood Acronyms Lead to HIPAA Mistakes
Be sure your staff knows these 5 common terms. Just because your providers and staff use ...
Read more
Reader Question:
Report Add-on Code Gap in Anesthesia Between Labor and C/S
Question: We have different opinions in our office on how to properly report this lab...
Read more
Reader Question:
Yes, You Can Code Ultrasonic Guidance With Some Line Placements
Question: Some of our doctors think they can code for ultrasound guidance with line p...
Read more
Reader Question:
Include Both Q6 and AA on Personally Performed Claim by Locums
Question: I know we need to include modifier Q6 for a locum tenens claim. If the phys...
Read more
Reader Question:
Steer Clear of Billing IM Injection With Additional Pain Meds
Question: We have an anesthesiologist who wants us to bill separately for an IM injec...
Read more
Reader Question:
Code 00944 Might Be Best for Laparoscopic Vaginal Hysterectomy
Question: What is the best anesthesia code for a laparoscopic vaginal hysterectomy? T...
Read more
Reader Question:
Cross Imaging Procedure 78740 to Anesthesia 01922
Question: What anesthesia code should we use for a voiding cystourethrogram (78740)? ...
Read more
Reader Question:
Choose Between 00400, 01260 for Sclerotherapy Anesthesia
Question: Our anesthesiologist was asked to be present during a sclerotherapy procedu...
Read more
You Be the Coder:
Modifier Selection for Residents, SRNAs
Question: I’m coding for an anesthesiologist with two concurrent cases – ...
Read more
Anesthesia Coding Alert - 2017; Volume 19, Number 3
CCI Edits:
Don't Miss the Correction to Moderate Sedation Edits
Hold off on applicable claims until April 1, to simplify reimbursement. As reported in th...
Read more
Coding Refresher:
Conduct an Internal Audit to Keep Documentation Skills Sharp
Heads up: Focusing on certain areas can help keep denials at bay. Every coder knows that ...
Read more
ICD-10:
Learn the Differences Between Central Benign Tumors for Neurosurgery Cases
Coding correctly is easy – when you know these keys. Your anesthesiologist is calle...
Read more
Reader Question:
Confirm Your Facility's Interpretation of 'Proxy' for Smoking Abstinence Questions
Question: One part of PQRS measure #404 (Anesthesiology smoking abstinence) states, &...
Read more
Reader Question:
Check the Criteria Before Including Critical Care Codes
Question: We have an intensivist who sees patients on the PICU floor, then puts the p...
Read more
Reader Question:
Code 00550 Is Better Than 00400 if There's Debridement
Question: Our anesthesiologist was present during surgery to treat sternal wound infe...
Read more
Reader Question:
Figuring Base Units for Qualifying Circumstance Code 99140
Question: The Relative Value Guide states that the add-on code +99140 has a base valu...
Read more
Reader Question:
Look to 01935 or 01936 for Anesthesia During Paravertebral Joint Block
Question: I know that anesthesia is "typically not required" with the services of 644...
Read more
Reader Question:
Here's What to Look for Before Reporting Swan-Ganz
Question: I see on the anesthesia records under “central line” that my pr...
Read more
You Be the Coder:
Mind Your Modifiers for Canceled Surgery Cases
Question: We are having problems with Medicare when we attach modifier 74 to claims. ...
Read more
Anesthesia Coding Alert - 2017; Volume 19, Number 2
CCI edits:
Say Good-bye to Reporting Anesthesia With These New Codes
Hint: Most apply to epidural choices. January brought a new version of Correct Coding Ini...
Read more
ICD-10:
Keep on Track With Updates to Vascular Diagnosis Codes
Plus: Don't miss the more specific choices for postprocedural hematoma, hemorrhage. Most ...
Read more
Practice Management:
Start the New Year With 5 Ideas for Extra Cost Savings
You might find budget boosts in some unexpected places. It's not unusual to head into a ...
Read more
Reader Question:
List O34.211 Before O80 on Your Claim
Question: I have been told the code for a successful VBAC would be submitted as O34.2...
Read more
Reader Question:
Your Anesthesiologist Cannot Administer Dental Anesthesia
Question: Can a medical anesthesiologist provide dental anesthesia for involved denta...
Read more
Reader Question:
Choose 00840 Over 00944 for Laparoscopic Assisted Vaginal Hysterectomy
Question: If a patient has a laparoscopic assisted vaginal hysterectomy, which anes...
Read more
Reader Question:
Use This Breakdown of Which Supervision/Direction Modifiers to Include
Question: I have some cases where a CRNA does the preoperative evaluation but does no...
Read more
Reader Question:
Get the Scoop on 'Malversiting' and Its Potential Effect
Question: I have some cases where a CRNA does the preoperative evaluation but does ...
Read more
You Be the Coder:
Cysto Code 52287 Anesthesia Crosswalk
Question: What anesthesia code would you use when billing for services during 52287...
Read more
Anesthesia Coding Alert - 2017; Volume 19, Number 1
Anesthesia 101:
Try Boosting New Year Dollars With P Modifiers
Extra units can add up if insurers are willing to pay. Physical status modifiers help exp...
Read more
Procedure Coding:
Get to Know the New Injection/Guidance Combos for 2017
You'll be using these a lot if your providers administer injections. If you sometimes cod...
Read more
Quality Reporting:
AMA Can Help You Choose the Best MACRA Model
Take advantage of their online tool. MACRA's Quality Payment Program (QPP) is set to begi...
Read more
Reader Question:
Leave P2 Off Medicare Claims
Question: We currently bill monitored anesthesia care (MAC) services by a CRNA. We su...
Read more
Reader Question:
Training Makes the Difference Between Performing 93312 and 93313
Question: A coder who is new to our practice says that you should code TEE differen...
Read more
Reader Question:
Include Modifier AD for Maxed-out Concurrent Cases
Question: I’m preparing a claim for our anesthesiologist with more than four ...
Read more
Reader Question:
Presence of Instrumentation Guides Fusion Coding
Question: Our CRNA provided anesthesia when a surgeon performed direct lateral interb...
Read more
Reader Question:
Here's the Scoop on Submitting +99140
Question: Our biller wants to report +99140 for the anesthesiologist’s p...
Read more
Reader Question:
Know the Best Times to Report Z Codes
Question: In our practice, we’re still getting used to the intricacies of the...
Read more
You Be the Coder:
Choosing Anesthesia for Lap-Assisted Vaginal Hysterectomy (LAVH)
Question: If a patient has a laparoscopic assisted vaginal hysterectomy, which anes...
Read more
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