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Anesthesia Coding Alert

Procedure Focus:
Follow 4 Steps to PICC Line Coding Success
Narrow down by type of line, pump usage, and patient age. Line placements are included in... Read more
Reimbursement:
Get Back to Basics to Ensure Part B Payment
Verify you're handling these two situations correctly. Medicare policies are never simple... Read more
Documentation:
Keep Your Electronic Signatures HIPAA Compliant
Consider encryption for an additional level of security. Providers across all medical spe... Read more
You Be the Coder:
Creating an AV Fistula With Nerve Block
Question: How should I code the anesthesia service for creating an AV fistula with a nerve... Read more
Reader Questions:
Submit Unlisted for an iPACK Block
Question: The anesthesiologist performed a nerve block procedure and the surgical procedur... Read more
Reader Questions:
Include Supporting Diagnoses for Anesthesia in Special Circumstances
Question: A patient had transthoracic echocardiography under MAC due to Down syndrome and ... Read more
Reader Questions:
New ABN Implementation Has Been Postponed
Question: I heard earlier this year that a new advance beneficiary notice (ABN) form ... Read more
Reader Questions:
No Medical Supervision Means No Payment for the MD
Question: In our state a nurse anesthetist can provide care under the supervision of or un... Read more
Reader Questions:
Look to 01936 for Anesthesia During Kyphoplasty
Question: Our providers offer kyphoplasty in the office setting. One physician performs th... Read more
Reader Questions:
Watch Your Starts and Stops
Question: When does anesthesia time start and stop? Virginia Subscriber Answer: Anesthes... Read more
CPT® 2021:
Look Ahead to These Code Revisions and Deletions for 2021
Updates focus on injection procedures. September brings cooler temperatures and thoughts ... Read more
Reimbursement:
Follow This Advice When Coding for ‘Substitute’ Physician
Correctly using one modifier makes all the difference. Needing a physician to temporarily... Read more
Compliance:
Get Ready for Closer Claims Reviews
Check the OIG work plan to be on the safe side. Despite the nation still being in the thr... Read more
Reader Questions:
Always Designate When MAC Is the Mode of Anesthesia
Question: Does the anesthesia record have to state when the type of anesthesia was MA... Read more
Reader Questions:
Capture Bilateral Rectus Sheath and TAP Blocks During Same Session
Question: The anesthesiologist administered a bilateral rectus sheath block from 3:35 to 3... Read more
Reader Questions:
Consider These Factors When Assigning Colonoscopy Diagnosis
Question: Our physician provided anesthesia during a colonoscopy for a patient with a hist... Read more
Reader Questions:
Use Operative Report as Your First Choice for Diagnosis Details
Question: This is an elementary question, but I'm new to anesthesia coding. Where is the b... Read more
Reader Questions:
Choose from These Codes for Special Venipuncture
Question: How do I code for venipuncture when the anesthesiologist is called to perform a ... Read more
Reader Questions:
Submit 01610 for Mastectomy Anesthesia
Question: The surgeon performed an axillary sentinel node biopsy in conjunction with a pa... Read more
You Be the Coder:
Look at These Codes for Gelfoam Dural Repair
Question: Our provider blocked a lumbar dural tear with a single piece of gelfoam. Would y... Read more
Reimbursement:
Prepare Now for Cuts to Anesthesia and National Conversion Factors
Proposed rule for MPFS 2021 also continues some changes due to COVID-19. August 3 brought... Read more
News You Can Use:
CPT® 2021 Will Bring Changes for Pain Management
Only code for anesthesia? You're set for 2021. Even in the midst of the uncertainty that ... Read more
Documentation:
Follow This Advice to Let Queries Improve Practice Communication
Whether written or verbal, get the clearest documentation possible. There is never a bad ... Read more
Reader Questions:
Include Modifier QS or G8 for MAC Services
Question: One of our providers excised a malignant lesion on the patient's forearm under g... Read more
Reader Questions:
Don’t Submit Modifier 58 for Your Anesthesiologist
Question: Is it appropriate to use modifier 58 on anesthesia encounters when the surgeon p... Read more
Reader Questions:
Verify Specific Pump and Service Before Billing for Refills
Question: I'm having trouble determining the best way to code for programmable pump refill... Read more
Reader Questions:
Claims Reviews Have Begun Again
Question: We've been glad to have a break from Medicare claims reviews during the past few... Read more
Reader Questions:
Streamline With 1 Labor Epidural Claim, if Possible
Question: We have a labor epidural that has two start and stop times by two anesthesiologi... Read more
Reader Questions:
Medicare Could Make COVID-19 Code Changes Permanent
Question: Are all these changes to telehealth and other forms of virtual medicine temporar... Read more
Reader Questions:
Get the Lowdown on NCCI Modifier Indicators
Question: I'm overwhelmed whenever I try to understand the quarterly updates from the Nati... Read more
You Be the Coder:
Choose This for EEG Anesthesia
Question: A patient had an EEG under general anesthesia due to behavioral issues and autis... Read more
Specialty Care:
Follow These Pointers for Post-op Pain Management Success
Tip: Always start with the surgeon's request for services. Every anesthesiologist provide... Read more
ICD-10-CM 2021 Update:
Don't Miss the New COVID-19 Code for ICD-10-CM
Newly introduced diagnosis becomes official Oct. 1; headache NOS expands. When the 2021 I... Read more
Compliance:
Data Sharing Grows in Importance, According to New CMS Rule
Stay smart by getting familiar with health IT requirements now. The importance of all asp... Read more
Reader Questions:
Clearly Document 'Emergency' to Support Submitting 31500
Question: A patient was taken to the OR for an “elective emergent intubation” under ge... Read more
Reader Questions:
Appending Modifier 22 Doesn't Allow for Extra Pre-op Pay
Question: I have an anesthesiologist asking if a pre-op history and physical could be sepa... Read more
Reader Questions:
Don't Hold Your Breath for Standby Service Payment
Question: Our group was asked if one of our providers could be on standby during a cash pa... Read more
You Be the Coder:
Here's What Differentiates TAP Catheter and Block
Question: What is a TAP catheter, and what's the correct way to code for it? Mississippi ... Read more
Code Update:
Look for New Diagnosis Codes That Can Help Specify Patient Status
 ICD-10-CM 2021 has a few revisions you might find handy. CMS has released diagnosis... Read more
Procedure Focus:
Understanding Segment vs. Interspace Makes a Difference in Spinal Coding
The key to successful spine claims can come down to counting. Coding for spinal treatment... Read more
Reimbursement:
Refresh Your Medicare Savvy With These 4 Reminders
Tip: Go back to basics and build from there. Slogging your way through Medicare claims ha... Read more
Reader Questions:
Watch for Clues About Inherent Hypothermia
Question: I know that +99116 can be added to some claims to represent hypothermia but... Read more
Reader Questions:
Check Whether ASA Allows Separate Anesthesia Codes for Some Services
Question: Our pain management specialist has hired an anesthesiologist to provide monitore... Read more
Reader Questions:
Watch These Markers for Start and End Times
Question: I'm brand new to anesthesia coding. When does anesthesia time start and stop? N... Read more
Reader Questions:
Code 99231 Could Be a Post-op Pain Relief Possibility
Question: Our providers have begun to administer a different type of nerve block for posto... Read more
You Be the Coder:
Choose This Code for Labor Without Delivery
Question: An expectant mom came to the hospital at the 37-week mark and was given an epidu... Read more
Coding Basics:
Brush Up on Your Critical Care Reporting Considering COVID-19
Let these four guidelines keep you on track. As healthcare systems continue to grapple wi... Read more
Coronavirus:
Double Check CMS Guidance Before Submitting COVID-19 Claims
Ever-changing policies make updates more important. As the coronavirus pandemic continues... Read more
News You Can Use:
Keep Up to Date with the OIG's Daily FAQs
Every practice has questions about financial arrangements — and enforcement regulations ... Read more
Reader Questions:
Bill Separate Codes for Anesthesia During Block
Question: One of our pain management specialists administered a facet block under MAC... Read more
Reader Questions:
Choosing the Correct Code for Pump Refills
Question: I'm having trouble determining the best way to code for programmable pump r... Read more
Reader Questions:
Home in on Correct Humeral Shaft Hardware Removal Code
Question: What anesthesia code should we report for removal of hardware from the hume... Read more
Reader Questions:
Don't Report 01961 if Mom Attempts Vaginal Delivery
 Question: Currently, when we code for anesthesia, we are only able to report on... Read more
You Be the Coder:
How to Bill for N95 Masks
Question: One safety measure our pain management office has implemented during the COVID-1... Read more
COVID-19:
You Need to Know Codes for Coronavirus Cases: Here's Why
You could also be reporting 31500 quite often. With many aspects of healthcare adopting a... Read more
News You Can Use:
Don't Miss the Latest Updates on Coding for Telehealth
Brush up on changes to guidelines, waivers. Telehealth is playing an ever-important role... Read more
Practice Management:
Think 'Empathy' Despite Stress of the Situation
Be conscious of how patients perceive care through virtual visits. Anesthesiologists us... Read more
Reader Question:
Follow These Points When Billing CRNA Service for Colonoscopy
Question: Can a CRNA bill Medicare for anesthesia during a colonoscopy? If so, what requir... Read more
Reader Question:
Check the Notes Before Assigning Foot Pain Diagnosis
Question: During a level-two evaluation and management (E/M) service for a new patient, ou... Read more
Reader Question:
Teach New Coders These Modifier 25 Tips
Question: I have been training several new coders, and a couple of them are having pr... Read more
Reader Question:
Diagnosis Z30.2 Can Pair With 00851
Question: While trying to bill anesthesia during a tubal ligation with 00851 and diagnosis... Read more
You Be the Coder:
Turn to These Codes for Rhizotomy Anesthesia
Question: What code should we report for anesthesia during facet joint rhizotomy? Ke... Read more
Compliance:
What Constitutes 'Short Duration' for Medical Direction Claims?
See if your anesthesiologist's service falls in these categories. Each time you file a cl... Read more
Checkpoint:
Remember to Meet 7 Criteria Before Reporting Medical Direction
Plus: Count cases to ensure it's not medical supervision instead. “Medical direction" d... Read more
Refresher:
Remember This Tip Before Appending Modifier 50
Clue: Start with the descriptor. Pain management providers performing bilateral procedure... Read more
Reimbursement:
Follow 6 Simple Facts to Find Success with the Fee Schedule
Glean the info you can, but don't ignore other resources. Staying on top of all the fede... Read more
Reader Question:
Verify a Patient's MBI Status
Question: I've had a few claims rejected for Medicare patients, even though I know I have ... Read more
Reader Question:
2 Procedures on Same Day Probably Need Separate Claims
Question: One of my providers administered anesthesia for a screening colonoscopy. The pat... Read more
Reader Question:
'Sedation' Doesn't Always Point to 99155 Code Set
Question: Our anesthesiologist used fentanyl and propofol to provide sedation during a 4-y... Read more
Reader Question:
Remember Extra Units for Pre-op H&P Aren't Allowed
Question: One of our anesthesiologists is asking if a pre-op history and physical might be... Read more
You Be the Coder:
Reporting Epidural Post-Op Pain Management
Question: How should requests for daily postoperative pain management be documented? Nor... Read more
Diagnosis Coding:
Follow 4 Steps to Successful Burn Diagnosis Selection
Site, severity, and type will guide your choice. In last month's issue of Anesthesia... Read more
Practice Management:
Pay Attention to Potential Changes to Incident-to Billing
Your months to report the service might be numbered. If you code for pain management ser... Read more
Compliance:
Find Your Own Fit for Documenting Risk
There's not a set form for you to follow. You know that assessing your practice's compli... Read more
Reader Question:
Include LT, RT Instead of 50 on 64420
Question: I know that some changes were made to codes 64420 and 64421 for 2020 and that yo... Read more
Reader Question:
Screening Status Determines Whether to Report Modifier PT
Question: A patient had an EGD with biopsy for dysphagia and a screening colonoscopy that ... Read more
Reader Question:
Bill Facility Services Under CRNA Name, Not Attending
Question: Our CRNAs are employed by the hospital. They sometimes perform supplemental proc... Read more
Reader Question:
Assign Modifier AD When Physician Maxes Out on Concurrent Cases
Question: Our anesthesiologist is billing more than four concurrent cases. How do we file ... Read more
Reader Question:
Code 93312 for TEE Crosses to 01922
Question: How should I code for anesthesia during a transesophageal echocardiography (TEE)... Read more
Reader Question:
Check Approach Before Coding Stress Incontinence Sling
Question: Our physician provided anesthesia during surgery to place a stress incontinence ... Read more
Reader Question:
Put These Patient Record Safeguards in Place
Question: A new front-desk staff member insists that our office is violating HIPAA by main... Read more
You Be the Coder:
Report This for Anesthesia During EEG
Question: A 31-year-old patient underwent an EEG under general anesthesia due to behaviora... Read more
Anesthesia 101:
Brush Up on Math Skills Before Submitting Burn Care Claims
Anatomic site is the key to your final choices. Coding for burn care can get tricky from ... Read more
Reimbursement:
Documentation Remains Key to Payment Success
Latest CERT report from CMS nails home the point. Documentation is always an important pa... Read more
News You Can Use:
FDA Confirms New Commissioner
Oncologist steps in as new leader. After having two different acting commissioners since ... Read more
Reader Question:
Add Modifiers for Complete Claims, Even Without Reimbursement
Question: Do we really need to include modifiers such as QS or patient status indicators s... Read more
Reader Question:
Choose J0475 Over J3490 for Baclofen Injection
Question: Our provider used a combination of baclofen, sodium chloride, and sterile water ... Read more
Reader Question:
Only the Sedation Provider Can Report 99152
Question: My provider performs procedures in an ASC and also works with a nurse to provide... Read more
Reader Question:
Begin with 01936 for Anesthesia During Kyphoplasty
Question: One of our physicians administered anesthesia during a patient's kyphoplasty pro... Read more
Reader Question:
Remember Modifier G8 for Monitored Anesthesia Care
Question: A provider excised a malignant lesion on the patient's forearm under genera... Read more
Reader Question:
Pay Attention to Global Period for Pain Pump Removal
Question: Our physician removed an implanted pain pump and catheter from a patient whose p... Read more
Reader Question:
Confirm 'Emergency' Associated with 31500 Claim
Question: A patient was taken to the OR for an “elective emergent intubation” under ge... Read more
You Be the Coder:
Shifting to Pump Oxygenator Mid-Procedure
Question: My anesthesiologist began a bypass case without the pump oxygenator, then went o... Read more
Documentation:
Check Even the Small Details Before Filing Your Claims
Positions, approaches, and more can make big differences. Every anesthesia coder knows th... Read more
Pain Management:
Bone Up on the Differences Between Discography and Decompression Before Assigning Codes
Hint: One procedure is diagnostic; the other is therapeutic. Discography and disc decompr... Read more
Regulations:
Here's Why You Should Keep Telemedicine and Opioid Claims Especially Clean
Be warned: The feds are watching for potential fraud. If you report telemedicine services... Read more
Technology:
Don't Let the Versatility of Devices Be Your Downfall
Follow these tips to shore up security. The more common and user-friendly mobile devices ... Read more
Reader Question:
Induced Hypothermia Doesn't Always Point to +99116
Question: When is it not correct to append +99116 for hypothermia? Louisiana Subscri... Read more
Reader Question:
Remember That Monitoring Vitals Is Part of Anesthesia Service
Question: Is there a billable code for monitoring oxygen and heart function during vein su... Read more
Reader Question:
Get the Lowdown on Non-typical Migraine Diagnoses
Question: I know about standard migraines and I think I have a grip on how to report the p... Read more
You Be the Coder:
Submit This for Epidural Patch Placement
Question: How do I code an epidural blood patch procedure on the same day as labor and del... Read more
Anesthesia Basics:
Follow This Guidance to Better Understand P Modifiers
Tip: Document the one that applies, even if you won't be reimbursed. Physical status modi... Read more
HCPCS Coding:
Catch All Your Potential Reimbursement for TPI Claims
Pay attention to all the options for reporting the drug. If you ever code for pain manage... Read more
Compliance:
Help Your Practice Battle Potential Privacy Breaches by Making Disclosure Easy
Remember that patient care is always your top priority. Incidental use — also known as ... Read more
Reader Question:
Watch Descriptor Details Before Reporting +77002 or +77003
Question: I'm having trouble understanding the differences between fluoroscopic codes +770... Read more
Reader Question:
Unanticipated Procedure During Global Period Requires 78
Question: Our physician removed an implanted pain pump and catheter from a patient whose p... Read more
Reader Question:
Surgical Approach Differentiates 00944 from 00840
Question: The Anesthesia Crosswalk crosses CPT® code 58550 to 00944, with 00840 as an alt... Read more
You Be the Coder:
Don't Make Assumptions About Induced Hypothermia
Question: When is it not correct to append +99116 for hypothermia? Louisiana Subscriber ... Read more
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