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Anesthesia Coding Alert

Coding Refresher:
Getting Tripped Up by 01967 Claims? Our Q&As; Keep Things Straight
Know when – and if -- +01968 comes into play. Coding for obstetrical cases always has t... Read more
Pain Management:
Confirm CTS Diagnosis to Start Down the Right Path
Answer one simple question before beginning to code. When you are coding for carpal tunne... Read more
Regulations:
More Flexibility for Opioid Treatment Could Be Coming
Feds say telemedicine could play a role. Substance abuse has plagued Americans for decade... Read more
Reader Question:
Sometimes Payers Might Need Extra Diagnoses
Question: The practice I recently began working with bills for anesthesia services during ... Read more
Reader Question:
Evaluate All the Options Before Billing TEE
Question: One of our anesthesiologists performs TEE prior to or during certain surgeries. ... Read more
Reader Question:
Append Modifier QS for MAC During Excision
Question: One of our providers excised a malignant lesion from a patient's forearm under M... Read more
Reader Question:
Make the Best Choice for Anesthesia During 61070
Question:  A patient needed anesthesia for services reported with 61070 and 75809. Wh... Read more
Reader Question:
Belly Button Differentiates 'Upper' from 'Lower' Abdomen
Question: What is the best way to determine the correct anesthesia codes for upper and low... Read more
Reader Question:
Don't Expect Payment for In-utero Anesthesia
Question: We had a unique situation in which two anesthesiologists were involved with care... Read more
Reader Question:
Watch the Payer Before Filing With Modifier PT
Question: We have only one diagnosis to support using anesthesia during a screening colono... Read more
You Be the Coder:
Coding for Anesthesia During EEG
Question: An EEG was performed on a patient under general anesthesia due to behavioral iss... Read more
Modifier Refresher:
Planning to Report Modifier QZ? Read These 3 Scenarios First
Different states can have different reporting requirements. The current HCPCS manual incl... Read more
Medicare News:
Keep Updating Patient Records as New Cards Are Sent
Prepare now for the complete switch-over in 2020. Another important step in shifting towa... Read more
Compliance:
Send CERT Documentation ASAP, When Asked
MACs are noticing that providers aren't being timely. If you've received a documentation ... Read more
Reader Question:
Fluoroscopic Guidance Is Part of 0275T for PILD
Question: Can we report fluoroscopy during PILD in conjunction with 0275T? Maine Subscrib... Read more
Reader Question:
Remember Locum Tenens Is for Physicians
Question: Can we bill a CRNA's service with a locum tenens modifier? He is filling in for ... Read more
Reader Question:
Combine Times to Bill Under One Provider, If Possible
Question: We have a labor epidural that has two start and stop times by two anesthesiologi... Read more
Reader Question:
Choose from E/M Codes to Cover Work Before Canceled Surgery
Question: Our anesthesiologist spent about 20 minutes on a Medicare patient's pre-anesthes... Read more
Reader Question:
Include Documentation to Support Anesthesia During EEG
Question: Our provider administered general anesthesia for a patient having an EEG; her ph... Read more
Reader Question:
CTS and TTS Are Similar, But Not Identical
Question: A new coder in our department told us that her previous practice treated patient... Read more
Reader Question:
Pay Attention to All the Options for TMJ Diagnoses
Question: How should I report a diagnosis of temporomandibular joint (TMJ) disorder? Mont... Read more
You Be the Coder:
Reporting Anesthesia for GI Endoscopy
Question: We have a debate in our office regarding how to bill for anesthesia during gastr... Read more
Procedure Focus:
Can You Report Anesthesia in Addition to Double Lumen Cath?
Read what some experts say. Your anesthesiologist documents that he administered general ... Read more
ICD-10:
Check Out These Diagnosis Changes for Pain Management
It's time to incorporate the updates for 2019. If you help code for a pain management spe... Read more
Breaking News:
Watch for CPT® Changes That Could Affect Your Coding in 2019
Hint: You'll see more updates for pain management than anesthesia. The American Medical A... Read more
Reader Question:
Report Standby Service Even If Payment Isn't Expected
Question: Our anesthesiologist was called into an in-office case to provide sedation for a... Read more
Reader Question:
Watch the Add-on Aspect of +76937 Before Filing
Question: We are billing ultrasound guidance +76937 x 2 when performing two procedures (su... Read more
Reader Question:
Remember the Modifier for Separate Line Placement Coding
Question: Our anesthesiologist administered general anesthesia during a procedure. He also... Read more
Reader Question:
Build Your Risk Plan Around These Questions
Question: Our practice is trying to evaluate our practice's liabilities and risks but we'r... Read more
You Be the Coder:
Reporting Modifier 58 for Your Anesthesiologist
Question: Is it appropriate to use modifier 58 on anesthesia encounters when the surgeon p... Read more
ICD-10:
Don't Miss These New Options for More Specific Diagnoses in 2019
Caveat: Your provider will still need detailed documentation for you to code correctly. T... Read more
Compliance:
Brush Up on How Hard HIPAA Violation Penalties Can Hit
No matter the cause, they're nothing to laugh at. Having a solid understanding of HIPAA r... Read more
Reader Question:
Get Clear Documentation to Support 01922-23 With MRI
Question: A child would not cooperate for an MRI procedure, so the provider asked our anes... Read more
Reader Question:
Include the Correct Modifier for Multiple 20550 Injections
Question: Our pain management physician administered four coccygeal ligament injections. S... Read more
Reader Question:
Intubation Outweighs Vent Management Service
Question: Can we bill Medicare for intubation (31500), ventilation assist/management (9400... Read more
Reader Question:
Stay Away from Modifier 58 on Anesthesia Claims
Question: Is it appropriate to use modifier 58 on anesthesia encounters when the surgeon p... Read more
Reader Question:
Verify Extubation Before Coding Two Procedure Times
Question: Upon emergence, a hernia repair patient experienced cardiac arrest, so staff beg... Read more
Reader Question:
You Can't Bill Separately for BP Monitoring
Question: Can we bill for blood pressure monitoring, pulse oximetry, and running a rhythm ... Read more
You Be the Coder:
Billing NG/OG Tube Placement In Addition to Anesthesia
Question: Our anesthesiologist administered general anesthesia for a case. He also provide... Read more
Coding Edits:
NCCI 24.2 Ties C9738, C9748 to Many Common Injection Procedures
Be sure you know how to handle the situation The latest round of National Correct Coding ... Read more
Compliance:
Is Your Office on Track for Big Changes to Medicare Cards?
The countdown has begun for full implementation by January 2020. The Centers for Medicare... Read more
Reader Question:
Don't Jump to Report Anesthesia With TPI
Question: Anesthesia was given when a patient had a trigger point injection because the pa... Read more
Reader Question:
Pass the Criteria Check Before Reporting Modifier 24
Question: The hospital requested that our anesthesiologist who will be administering anest... Read more
Reader Question:
Code 62263 Covers Multiple Session Days
Question: My physician performed an epidural lysis and administered three injections over ... Read more
Reader Question:
Submit 96103 for Behavioral Health Screening
Question: What code applies to behavioral health screenings for patients who are in chroni... Read more
Reader Question:
Get the Lowdown on TIVA vs. MAC
Question: I was always under the impression that total intravenous anesthesia (TIVA) was c... Read more
Reader Question:
Keep Tabs on Your MIPS Status
Question: My practice is transitioning to Merit-Based Incentive Payment System (MIPS&#... Read more
Reader Question:
Pinpoint the Best Diagnosis for Post-laminectomy Syndrome
Question: The provider consulted with a patient two weeks after a cervical laminectomy for... Read more
You Be the Coder:
Count Time Carefully With Line Placements
Question: A patient arrives at the OR at 7:30 a.m. The anesthe­siologist places an A-line... Read more
Add-on Codes:
Think of 3 Things Before Adding +99100 to Your Claim
Qualifying circumstances can boost pay in some cases. Qualifying circumstances codes migh... Read more
QC Codes:
Refresh Your Memory on Qualifying Circumstances Codes
Don't overlook the potential for extra reimbursement. Qualifying circumstances (QC) codes... Read more
Pain Management:
Coding for Somatic Nerve Block? Remember Your Anatomy
Pay special attention to trigeminal and GON injections. If your anesthesia provider also ... Read more
Reader Question:
Remember Swan-Ganz 93503 Includes 36556
Question: Our anesthesiologist recently documented that we should code for a central line,... Read more
Reader Question:
Verify Details Before Coding Same-day Blood Patch
Question: How do I code an epidural blood patch procedure on the same day as labor and del... Read more
Reader Question:
Anesthesia for Pediatric Blood Draw Leads to 00400
Question: What anesthesia code should I use for a 5-year-old who was given general anesthe... Read more
Reader Question:
Watch the Details for 01967/+01968 Combo Claim
Question: The anesthesia provider administered an epidural for pain management during a pa... Read more
Reader Question:
Purpose of Procedure Separates SI Injection From Arthrogram
Question: What is the difference between a sacroiliac (SI) joint injection and an SI joint... Read more
You Be the Coder:
Key Points for Postop Catheter Coding
Question: Our provider used monitored anesthesia care (MAC) for the primary mode of anesth... Read more
Qualifying Circumstances:
Follow 3 Tips Before Adding +99135 to Your Claim
Good documentation is especially key. The anesthesia section of CPT® includes four add-o... Read more
Security:
Focus on 5 Areas to Reduce Your Risk of PHI Breaches
Educating front desk staff is a must Every practice wants to avoid – or at least reduce... Read more
Compliance:
Use This Tool to Keep Tabs on MIPS
CMS has made it easier to check your status. Compliance and quality programs can be trick... Read more
Reader Question:
Trade 99152 for G0500 With Medicare Advantage
Question: BCBS Medicare Advantage is denying claims with 99152 and +99153, saying it's a n... Read more
Reader Question:
CRNA Administering Sedation During MRI
Question: Our CRNA performed moderate sedation during an MRI. Is this a payable service? I... Read more
Reader Question:
Steer Clear of 'Unspecified' Diagnosis for Abortion
Question: Our provider documented that he performed a D&C for an incomplete abortion. ... Read more
Reader Question:
Therapeutic Femoral Nerve Block = 64448
Question: How should I code a therapeutic nerve block of the femoral nerve when our pain m... Read more
Reader Question:
Watch the Details Before Coding CVP or PAC
Question: If the surgeon discontinues a procedure after anesthesia, is it appropriate to a... Read more
Reader Question:
Know What Distinguishes TIVA from MAC
Question: I was always under the impression that total intravenous anesthesia (TIVA) was c... Read more
You Be the Coder:
Watch the Details Before Coding CVP or PAC
Question: What documentation do we need from our anesthesiologist to support coding for CV... Read more
Qualifying Circumstances:
Don't Let Hypothermia Coding Stop Your Claims Cold
Refresh your knowledge on 4 key points to +99116. Qualifying circumstances codes can help... Read more
Security:
Do You Know What These 10 Cyber Terms Mean?
You'd better, if you want to keep your information protected. No matter how up-to-speed y... Read more
Quality Measures:
Heads-Up on Some Potential Medicare Revamping
EHR system could see big changes. Technology in healthcare has some definite advantages, ... Read more
Reader Question:
Report Mediport Placement With 36561 – Possibly
Question: I am coding a case for a patient with breast cancer (C50.912, C77.3) who receive... Read more
Reader Question:
Choose 'Unlisted' 64999 for ESP with PCA Catheter
Question: What is the correct CPT® code to use for an erector spinae block where a cathet... Read more
Reader Question:
Check Whether Payer Prefers Dental Code or 00170
Question: Can a medical anesthesiologist bill dental (CDT®) anesthesia codes for general ... Read more
Reader Question:
Leave Time Calculations Off Claims for ESI
Question: When you bill out codes 99151-+99157, don't you enter this on the professional c... Read more
Reader Question:
File Ketamine Infusion With 99999 and Stellar Documentation
Question: A psychiatric patient with severe depression and pain was taken to our ECT suite... Read more
Reader Question:
Code 62263 Covers a Series of Injections
Question: My physician performed an epidural lysis and administered three injections over ... Read more
Reader Question:
Know Your Options for Joint Aspiration and Injection Coding
Question: Encounter notes indicate that the physician performed a knee aspiration and a kn... Read more
You Be the Coder:
Crosswalk Choices for Intubation Code 31500
Question: A 16-week-old had multiple medical conditions including rhizomelic chondrodyspla... Read more
Procedure Focus:
Follow These 4 Steps to Simplify Your Gastro Claims
Hint: Showing medical necessity can make all the difference. Reporting anesthesia during ... Read more
Pain Management:
Pinpoint Your Best Possibilities for TPI Diagnoses
Two CPT® codes can tie in with multiple ICD-10 choices. Patients with chronic pain issue... Read more
HIPAA News:
CMS Asks for Ideas to Improve Quality Measures
Here's your chance to share input on EHRs. The Centers for Medicare and Medicaid (CMS) pu... Read more
Reader Question:
'General' Vs. 'MAC' Answers Whether Post-op Block Is Billable
Question: We are an ASC billing for the facility side of claims. I'd like to know if we ca... Read more
Reader Question:
Pre-anesthesia Work Isn't the Same As Consult
Question: I have recently had some discussion with our office adminis­trator as to why we... Read more
Reader Question:
Do Not Report Separately for Failed Epidural
Question: How should we bill a failed epidural when a different provider performed the pro... Read more
Reader Question:
Turn to 00562 for Pump Oxygenator During CABG
Question: Our anesthesiologist used a pump oxygenator during a coronary artery bypass graf... Read more
Reader Question:
Check Out M77 for Metatarsalgia Diagnosis
Question: Our pain management specialist has diagnosed a patient with metatarsalgia. What ... Read more
Reader Question:
HPI Protection Stays in Place for 50 Years
Question: How long do I need to maintain a patient's private health information after that... Read more
You Be the Coder:
Stone Location Helps Guide Anesthesia Code Selection
Question: How should I code for anesthesia during a cystoure­throscopy with lithotripsy f... Read more
Dental Procedures:
Know What the Payer Wants Before Coding Anesthesia for Dental Cases
Hint: Focus on the medical-- not the dental -- payer. Many dental procedures don't requir... Read more
Practice Management:
Reporting Locum Tenens? Here's What You Need to Know
These 4 expert tips will keep your reimbursement on the right track. No matter what type ... Read more
Terminology Check:
What Is a Locum Tenens Provider?
Know that Medicare approves of their use. "Locum tenens" is a Latin phrase meaning "to ho... Read more
Computer Security:
Hack the Hackers' Efforts by Taking These Simple Steps
Important: Make 'malvertising' more difficult on your systems. Healthcare hackers have a ... Read more
Reader Question:
Code 01214 Represents Spinal Anesthesia for Hip Arthroplasty
Question: What is the correct code for spinal anesthesia for hip arthroplasty? Wisconsin ... Read more
Reader Question:
Rely on 01922 for MAC During Radiotherapy
Question: Our physician provided monitored anesthesia care (MAC) during radiotherapy for a... Read more
Reader Question:
Turn to 00160 for Nasal Hemorrhage Anesthesia
Question: Our physician noted "EUA [exam under anesthesia] control bleed" in the notes for... Read more
Reader Question:
Go With 01961 for C-section, Nothing for Injection
Question: Our anesthesiologist administered spinal anesthesia for a cesarean section and a... Read more
Reader Question:
00520 Works for Pacemaker Lead Removal
Question: Is 00530 the best anesthesia code for removal of an infected pacemaker lead? One... Read more
Reader Question:
Reporting Unsuccessful Line Placement
Question: Can we code for a line placement (such as an arterial line or CVP) that the anes... Read more
Reader Question:
Surgical Method Determines Spine Biopsy Code
Question: What CPT® code should I submit for a biopsy of the sacral spine? Florida Subsc... Read more
Reader Question:
Reporting Post-procedure Pain Consult Instead of Service
Question: A surgeon requested that our anesthesiologist evaluate a patient regarding posto... Read more
You Be the Coder:
Here's Your Lowdown on Field Avoidance
Question: Can you remind me of the rules of field avoidance? What is required for document... Read more
CVP Coding:
Remember These 6 Tips to Find Line Placement Coding Success
Digging for details helps you cull through the choices. Line placement is one of the serv... Read more
Procedure Focus:
Follow This Advice for Spot-on CTS Coding
Hint: You can sometimes submit 20526 with a non-CTS diagnosis. Coders always want the mos... Read more
HCPCS Check:
Pay Attention to Drug Amounts for Correct CTS Injection Coding
Code 20526 doesn't automatically point to a certain medication. When you code for therape... Read more
Reader Question:
Follow Payer Rules for Colonoscopy That Shifts From Screening to Diagnostic
Question: I'm looking for some insight into how to utilize the new anesthesia codes for GI... Read more
Reader Question:
Submit 00902 for Prostate Massage Under MAC
Question: A patient presented for an exam under anesthesia with prostate massage. The anes... Read more
Reader Question:
Turn to 'Unlisted' for Anesthesia During EEG
Question: I have a patient that an EEG was performed under general anesthesia due to behav... Read more
You Be the Coder:
Correct PCEA Coding
Question: Our anesthesiologist placed a thoracic epidural preoperatively with the intentio... Read more
Reimbursement:
Prepare Now for Changes to Conversion Factor, Base Units in 2018
Plus: Don't miss one difference between CMS and RVG values. Updates to the anesthesia con... Read more
Hot Topic:
Verify Appeals Go to the Correct Group
Hint: Second levels don't go to MACs. There's no doubt that CMS paperwork can be confusin... Read more
Compliance:
Ask These Questions to Bolster Your EHR Risk Management
Pay special attention to who has access – and what they can do. It's easy to depend on ... Read more
Reader Question:
Remember Modifier AD When Anesthesiologist Passes 4 Concurrent Cases
Question: I'm still learning the ins and outs of anesthesia coding. What are Medicare's ru... Read more
Reader Question:
Think 'Face Time' When Deciding New vs. Established Status
Question: We saw a patient for pain injections earlier in the year and he is now coming in... Read more
Reader Question:
Prostate Biopsy 55700 Crosses to Anesthesia Code 00902
Question: What is the correct anesthesia code used for a prostate biopsy? I have been usin... Read more
Reader Question:
Verify Injection Type Before Reporting Epidural Code
Question: Our physician used X-ray under fluoroscopy to complete what he called an "epidur... Read more
Reader Question:
Codes for Eye Surgery Depend on Type of Service
Question: One of our new anesthesiology clients works in an eye center. He says that he on... Read more
You Be the Coder:
Submit Multiple Diagnoses for C-section, Failed VBAC
Question: A patient had a C-section following a failed VBAC due to fetal distress. She had... Read more
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