Anesthesia Coding Alert

Coding Basics:
Unusual Circumstances? Remember These 4 Steps Before Appending Modifier 23.
Let patient-specific details guide your choice. Modifier 23, unusual anesthesia, monitore... Read more
Diagnosis Coding:
Consider These Points When Choosing Cervical Disc Disorder Diagnoses
Check whether a single diagnosis code will suffice. When you're trying to pinpoint the m... Read more
Reimbursement:
Follow These 5 Steps to Improve Your Appeals Success
Tip: Know your “why” to better explain it to the insurer. Having the ability to appe... Read more
Reader Questions:
Consider These Points Before Appealing a Denial
Question: Our physician was providing anesthesia during a screening colonoscopy when the g... Read more
Reader Questions:
Code 99313 Is Often the Best Option for TEE
Question: One of our CRNAs wants to bill 93318 for a TEE (transesophageal echocardiograph... Read more
Reader Questions:
Remember This Detail About MAC
Question: The case I'm billing for was scheduled as MAC (monitored anesthesia care). The a... Read more
Reader Questions:
Here’s Your Explanation of Anesthesia Time
Question: I'm new to anesthesia coding. Can you explain what's meant by “anesthesia time... Read more
Reader Questions:
Classify “Retinal Migraine” as “Migraine with Aura”
Question: Our pain management provider diagnosed a patient with “retinal migraine.” I'... Read more
You Be the Coder:
Lean Toward This Code for Post-op Bier Bock
Question: What is the appropriate CPT® code for a postoperative Bier block for pain manag... Read more
Procedure Focus:
Code Retrobulbar Blocks Based on Other Service Offered, Payer Guidelines
Choose carefully between surgical and anesthesia code options. Retrobulbar block placemen... Read more
Reimbursement:
Appealing Medicare Denials? Take This Expert Advice to the Bank
Dig for details that will help your cause. Appealing Medicare claims decisions you beli... Read more
Practice Management:
Incorporate These 3 Tips to Smooth New Provider Onboarding
Hint: Lay the foundation with stellar organization. Fall can mean an influx of new prov... Read more
Reader Questions:
Pay Attention to Which Group of MAC Codes to Use
Question: Should we report monitored anesthesia care (MAC) in addition to the procedure c... Read more
Reader Questions:
POS 11 Is Legitimate for Anesthesia Services
Question: My anesthesiologist has been asked to perform anesthesia in an office surgi... Read more
Reader Questions:
Turn to 01996 Rather Than 99231 for Epidural Follow-up
Question: Our anesthesia providers do rounds on patients following delivery to check on th... Read more
Reader Questions:
Forearm Lesion Excision Crosses to 00400
Question: One of our providers excised a malignant lesion on the patient's forearm under g... Read more
Reader Questions:
Get Familiar with the Difference Between “Exacerbation” and “Chronic”
Question: Please settle this debate. One of our providers is saying that we should always ... Read more
Reader Questions:
No, You Cannot Withhold Records Because of Balance
Question: One of our patients has a sizable balance and hasn't responded to requests for p... Read more
You Be the Coder:
Submit This for Nasogastric Tube Placement
Question: I bill for a children's hospital and a small child was brought to the OR and ane... Read more
Documentation:
Follow These 4 Steps to ‘Unlisted Procedure’ Success
Keep your supporting documentation simple but clear. Every coder wants to be as specific... Read more
Coverage:
Take a Fresh Look at Your State’s Telehealth Laws
Hint: All doesn't remain equal across state lines. Telehealth services and the waivers an... Read more
Diagnosis Coding:
These Upcoming ICD-10 Changes Factor into Patient Circumstances
Pay special attention to the options in 3 categories. When ICD-10-CM changes go into ef... Read more
Reader Questions:
Stick with Cervical/Thoracic Code for Block to T12-L1
Question: The pain management provider administered medial branch blocks at T10 -T11 and T... Read more
Reader Questions:
Start with 00400 for Anesthesia During Dressing Change
Question: What is the correct code for reporting a dressing change under sedation? P... Read more
Reader Questions:
Get Documentation in Order to Justify Medical Necessity
Question: How do you handle the medical necessity for anesthesia on a procedure that, acco... Read more
Reader Questions:
Watch Payer for Use of Modifier PT
Question: On a recent audit, I had a deduction for the use of the PT modifier. I've been t... Read more
Reader Questions:
Report Tendon Sheath Injections with 20550
Question: I'm new to pain management, but it seems like I'm always coding for a tendon sh... Read more
You Be the Coder:
Use This Simple Solution to Report More Modifiers
Question: We are billing for anesthesia and have a Blue Shield claim that needs five modif... Read more
Line Placement:
Ask Yourself 5 Questions Before Coding Central Venous Catheter Insertion
Drill down to the details for easy code selection. When you code central venous catheter ... Read more
Claim Details:
Remember Your Modifiers with Line Placements
Check whether your payer requires 59. Because providers normally perform line placements ... Read more
ICD-10 Update:
Zero in on More Specific Diagnoses for Low Back Pain
Look ahead to code changes in October. Fall brings cooler weather and changing leaves –... Read more
Government:
Here’s How Lessons from Pandemic Led to Technology Legislation
Broadband bills aim to balance inequities. Data gathered during the pandemic has led to... Read more
Reader Questions:
Insurer Might Want Modifier 22 for Overly Long L&D Case
Question: One of our private insurers previously processed claims for labor epidurals with... Read more
Reader Questions:
Yes, You Can Code for Anesthesia During ESIs—Sometimes
Question: What anesthesia code do you bill when anesthesia is performed for transforaminal... Read more
Reader Questions:
Gather Rib Fixation Details before Choosing Crosswalk
Question: I'm coding for anesthesia during rib fixation surgery. What's your advice o... Read more
Reader Questions:
Begin Your Venous Insufficiency Diagnosis Search with I87.2
Question: A CRNA performed an IV insertion on a patient who was in the GI lab. The reason ... Read more
Reader Questions:
Feds Are Still Enforcing Patients’ Right of Access to Records
Question: We had an interesting discussion in our office recently about giving patients ac... Read more
Reader Questions:
Know the Differences Between Venipuncture Code Families
Question: Aside from the age restrictions specified in the descriptors, what is the differ... Read more
You Be the Coder:
Turn Here for Anesthesia During Open Cholecystectomy
Question: A patient scheduled for an open cholecystectomy was found to have severe gangren... Read more
Line Placement:
This Simple Checkpoint Will Confirm Whether Separate Swan-Ganz Coding Is Correct
Hint: Location always matters. In most of the cases you code, all the services provided ... Read more
Line Coding Basics:
All Lines Are Not Created Equal
Here's how you should code the most common categories. An anesthesia provider often uses ... Read more
Compliance:
Pay Attention to State Rules in the Post-Pandemic Health World
Note: You're especially at risk if services cross state lines. If you code for services t... Read more
Patient Privacy:
Don’t Let Pandemic Priorities Overshadow HIPAA Rules
Brush up on the basics – and associated penalties. If your organization is digging out ... Read more
Reader Questions:
Submit 64400 for Masseter Muscle Injection
Question: Our pain management specialist wants to administer a bilateral masseter muscle i... Read more
Reader Questions:
Bill for Time of Canceled Case, but Don’t Include Modifier 53
Question: My provider was scheduled to perform a Vertiflex on a patient in the ASC. After ... Read more
Reader Questions:
Meet the “7 Rules” Before Reporting Medical Direction
Question: I'm new to anesthesia coding. Can you explain the medical direction “rules” ... Read more
Reader Questions:
Don’t Fret Over the Shift to ICD-11 Yet
Question: I listened in on a webinar recently where the speaker said to prepare now for IC... Read more
Reader Questions:
Begin in S13 Code Family for Neck Sprain Diagnosis
Question: My pain management specialist treated a patient who was complaining of neck pain... Read more
Reader Questions:
PCA Placement Isn’t Billable by Anesthesiologist
Question: I have a case in which a patient was not a candidate for a labor epidural. The p... Read more
You Be the Coder:
Report This for Anesthesia During Nasogastric Tube Placement
Question: I bill for a pediatric hospital. A small child was brought to the OR and anesthe... Read more
Obstetrics Care:
Focus on These 4 Areas to Ease Your Labor Epidural Coding
Accurate documentation can carry the claim. An anesthesia claim is based on a combination... Read more
Diagnosis Coding:
Reporting Sciatica Is Simple – When You Watch These Details
Pay special attention to accompanying conditions. Before you assign ICD-10-CM codes to an... Read more
Documentation:
Get the Details You Need by Crafting Clear Queries
Tip: Start by educating yourself to avoid losing credibility. Crafting an easily under... Read more
Reader Questions:
Append a Modifier to Report Return to Surgery
Question: I am coding for a Medicare patient who returned to the OR for chest exploration ... Read more
Reader Questions:
Verify Documentation for +76937 with Line Placement
Question: Can we receive separate payment from Medicare or Medicaid when the physician use... Read more
Reader Questions:
Don’t Report 01967 for Non-Obstetric Epidurals
Question: Some surgeons have started requesting that our providers use epidural anesthesia... Read more
Reader Questions:
Getting Patient Approval of Secure Communication
Question: Is patient consent required under HIPAA before we can share encrypted communicat... Read more
Reader Questions:
Remember These Criteria Before Billing Consultations
Question: Our pain management specialist offered consultation services to a patient who wa... Read more
You Be the Coder:
Choose This Code for Erector Spinae Block
Question: I've reported CPT® code 64999 for an erector spinae pain block for years, but m... Read more
Procedure Focus:
Make Sense of Your Code Choices to Ensure Endoscopic GI Claims Success
Hint: Your best starting point is confirming screening vs. diagnostic. Endoscopic and GI ... Read more
Documentation:
Check for Other Modifiers During GI Procedures
Include every detail of the service in your claim. Many anesthesiologists administer MAC ... Read more
Procedure Focus:
Let This Q&A Clear Up Your Chemodenervation Questions
Pay attention to details such as accompanying services you can report. When your pain man... Read more
Compliance:
Stay on Track with OCR Guidance Surrounding COVID-19
Sharing patient information with authorities shouldn't cross privacy lines. Although we'r... Read more
Reader Questions:
Don’t Include +01969 if Patient Has No Labor Analgesia
Question: I am coding for a patient who did not have labor analgesia but later had anesthe... Read more
Reader Questions:
Pay Attention to Purpose of 62322 Before Pinpointing Anesthesia Code
Question: Is it appropriate to bill monitored anesthesia care (MAC) anesthesia for a cauda... Read more
Reader Questions:
Begin with 01936 for Anesthesia During Kyphoplasty
Question: One of our physicians is questioning whether 01936 accurately reflects the work ... Read more
Reader Questions:
No “Status Migrainosus” Mentioned in Notes? Go with G43.509
Question: Notes indicate that the provider performed an office/outpatient evaluation and m... Read more
You Be the Coder:
Reporting J2795 and 64450 Together
Question: When we file J2795 with 64450, we get denials stating the codes are bundled. Is ... Read more
Teamwork:
Make the Most of Claims With Multiple Anesthesia Providers
Watch your modifiers for correct accountability – and don't forget GC. It's not uncomm... Read more
Coding Tip:
Get Clarity From These Expanded Modifier Descriptors
Hint: They might give new coders a clearer understanding. The Relative Value Guide (RVG) ... Read more
Practice Management:
Stay on Top of OSHA’s Latest COVID-19 Guidelines
Remember your responsibility to staff, not only patients. In the ever-changing world of h... Read more
Partnerships:
Be Sure Your BAs Are on Board with HIPAA – Before It’s Too Late
Remember they're under the same HIPAA regulations as your practice. One of your most crit... Read more
Reader Questions:
Code 00630 Applies to Discontinued Vertiflex Procedure
Question: Our anesthesia provider began administering MAC (monitored anesthesia care) and ... Read more
Reader Questions:
Think “Belly Button” for Upper/Lower Dividing Line
Question: I'm attempting to code anesthesia during a colectomy. Where would the incis... Read more
Reader Questions:
Remember That 01967 Is Specific to Obstetrics
Question: My surgeons have started using epidural anesthesia in lieu of general anesthesia... Read more
Reader Questions:
Ensure Supporting Documentation Before Shifting from 00630 to 00670
Question: One of our providers uses 00630 for a lumbar microdiscectomy. Can the procedure ... Read more
Reader Questions:
Turn to 36400 or 36410 for Difficult Venipuncture
Question: How do I code for venipuncture when the anesthesiologist is called to perform a ... Read more
Reader Questions:
Choose an E/M Code for Lumbar Drain Placement Follow-up
Question: Our anesthesiologist placed a lumbar drain that was left intact for several days... Read more
You Be the Coder:
Epidural Insertion Code Outweighs Time Factor
Question: What amount of time should we include on the claim for epidural removal followin... Read more
Coding Refresher:
Yes, You Can Automatically Add Extra Base Units to Some Procedures
How? It's all thanks to these circumstances. As an anesthesia coder, you know that the nu... Read more
Practice Management:
Think Twice Before Mandating COVID Vaccines for Staff
Learn the facts and be prepared for questions. To protect both patients and staff against... Read more
Compliance:
Know Who Counts as ‘Healthcare Personnel’ Related to COVID-19
Hint: The list might be longer than you expect. As COVID-19 vaccination becomes more wide... Read more
You Be the Coder:
Use This as Anesthesia Code for 43752
Question: I bill for a children's hospital and a small child was brought to the OR and ane... Read more
Reader Questions:
Begin Your Compounded Drug Claim with the Correct J Code
Question: Every time I think we've figured out how to bill for pain pump refill medication... Read more
Reader Questions:
Rely on Surgical Note for Anesthesia Code Clues When Possible
Question: What do you find to be the best place to pull the diagnosis for anesthesia servi... Read more
Reader Questions:
Look at Low-level E/M When Patient Expires Before Surgery
Question: A patient with a stab wound to the right chest wall (with hemopneumothorax) was ... Read more
Reader Questions:
Turn to Standard C-section Codes for EXIT Procedure
Question: One of my anesthesiologists is asking whether we can bill for an EXIT procedure ... Read more
Reader Questions:
Choose from R20 Family for Allodynia Diagnosis
Question: What is the best diagnosis code for allodynia? Oklahoma Subscriber Answer: All... Read more
Reader Questions:
‘In Attendance’ for Upper GI Care Usually Translates to 00731
Question: Our anesthesiologist was “in attendance” during an inpatient surgery but nev... Read more
Reader Questions:
Employ Your Math Skills to Reach Correct Burn Codes
Question: Which anesthesia codes are used to report burn excision or debridement? Montana... Read more
Anesthesia Tactics:
Follow These 3 Steps to Understand TIVA vs. MAC
Hint: Think administration, not patient state. While most patient records you code from w... Read more
Diagnosis Focus:
Keep This Guide Handy for Resolving Back Pain Diagnoses
Plus: Get real-world help with the M54.- codes. Back pain is no laughing matter, whether... Read more
Compliance:
Learn Your Lesson from These Fraud and Abuse Cases
Don't set yourself up to be a DOJ target. If you thought still dealing with a pandemic wo... Read more
Reader Questions:
Report ‘Unlisted’ for Anesthesia During EEG
Question: An EEG was performed on a patient under general anesthesia due to behaviora... Read more
Reader Questions:
Use the Correct ABN Form in 2021
Question: How do I know whether I'm using the correct advanced beneficiary notice (AB... Read more
Reader Questions:
Submit Either 64487 or 64489 for a TAP Catheter
Question: What is a TAP catheter, and what's the correct code for it? Illinois Subscriber... Read more
Reader Questions:
Get Specific with your Achilles Injury Diagnosis
Question: A patient received pain treatment for a right Achilles injury; there is no other... Read more
Reader Questions:
Follow These Tips to Protect Your Practice from Scams
Question: What's the difference between phishing and vishing, and how can we protect ourse... Read more
You Be the Coder:
Steer Clear of This Code for Non-obstetric Epidural
Question: Some surgeons have started requesting that our providers use epidural anesthesia... Read more
Standby Service:
Follow This Advice for 99360 – or Get Left Standing on Your Own
Documentation and length of time are crucial factors. A surgeon asking an anesthesiologis... Read more
CPT® Check:
Ignore This Code When Reporting Standby Service
Don't get tripped up by L&D option. CPT® has only one code in the E/M section repres... Read more
Procedure Focus:
Get Your Diagnosis Straight Before Reporting These Injections
Hundreds of associated conditions make clearing through the clutter imperative. Injection... Read more
HIPAA:
Watch These Dos and Don’ts to Protect Patient PHI During COVID-19
The feds have sanctioned some HIPAA flexibility measures during the PHE. Even though you ... Read more
You Be the Coder:
Remember This When Coding Swan-Ganz
Question: Our surgeon performed a Swan-Ganz procedure, placed a central line through the s... Read more
Reader Questions:
Nasal Hemorrhage Leads to 00170
Question: Our physician noted "EUA [exam under anesthesia] control bleed" in the note... Read more
Reader Questions:
Start Fresh if ‘Unprocessable’ Claim Is Returned
Question: We received an “unprocessable” claim from our MAC. Can we appeal this? Ohio... Read more
Reader Questions:
Count Injections to Specific Nerves for 64415
Question: The CRNA administered a brachial plexus block. He wants to bill this with e... Read more
Reader Questions:
Complexity Drives Venipuncture Code Choice
Question: Aside from the age restrictions, what is the difference between venipuncture cod... Read more
Reader Questions:
Meet the Criteria for Critical Care Services
Question: The hospital requested that our anesthesiologist who will be administering anest... Read more
2021 Coding:
Prepare for These Drops to National and Anesthesia Conversion Factors
Final rule for 2021 hits providers across specialties. Get ready to see less on your bott... Read more
Procedure Focus:
Pinpoint This Condition before Filing for Acupuncture Pay
Here's how the 2020 payment policy has worked out. In 2020, Medicare made up its mind to ... Read more
Practice Management:
Stay Cognizant of Employees’ Privacy Rights When Testing for COVID-19
Guidelines keep changing, so keep up to date to stay compliant. If your practice has aske... Read more
You Be the Coder:
Submit This Code for Latissimus Dorsi Graft
Question: Which anesthesia code corresponds with the grafting procedure using a muscle fla... Read more
Reader Questions:
Ensure You’re Using the Correct ABN Form in 2021
Question: Our office has a few different versions of advance beneficiary notice (ABN) form... Read more
Reader Questions:
Always Code According to the Highest Base Procedure
Question: I know to bill code 00630 for a microdisectomy procedure. The patient is in pron... Read more
Reader Questions:
Code Transforaminal Epidural Based on Targeted Levels
Question: The physician documented TFESI at levels L4 and L5. Is this correct, or should h... Read more
Reader Questions:
Document Qualifying Circumstances Even Without Reimbursement
Question: I am new to anesthesia billing and have learned that Medicare and Medicaid do no... Read more
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