Anesthesia Coding Alert

No new anesthesia codes were added to CPT 2000, but 13 existing codes were revised, and 11 were deleted. Many of these changes were made in a effort to help align CPT codes with the current AMA (American Medical Association) codes, according to Stanley Stead, MD, advisor to the CPT Advisory Panel for the American Society of Anesthesiologists. Other reasons for the changes included:

- Making anesthesia codes consistent with surgical codes for the same procedure
- Consolidating codes if the procedures involved essentially the same level of
anesthetic management
- Correcting duplicate codes
- Clarifying definitions to help eliminate confusion between similar codes
- Expanding the use of codes to include more procedures
- Correcting or elaborating on definitions that were too restrictive

Definitions for the affected codes are provided below, but please consult the 2000 CPT for complete information.

Revised Anesthesia Codes

- Head
00100Anesthesia for procedures on salivary glands, including biopsy
00102Anesthesia for procedures on plastic repair of cleft lip
00103Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis
surgery)
00214Anesthesia for burr holes, including ventriculography

- Neck
00300Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified

- Thorax (Chest Wall and Shoulder Girdle)
00400Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified

- Intrathoracic
00520Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified
00528Anesthesia for mediastinoscopy and diagnostic thoracoscopy

- Upper Abdomen
00740Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum

-p Lower Abdomen
00810Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum
00857Neuraxial analgesia/anesthesia for labor ending in cesarean delivery (includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)

-p Perineum
00918Anesthesia with fragmentation, manipulation and/or removal of ureteeral calculus
00952Anesthesia for hysteroscopy and/or hysterosalpingography
00955Neuraxial analgesia/anesthesia for labor ending in a vaginal delivery (includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)

CPT 2000s New Modifier The layout of CPT 2000 is basically the same as the 1999 version, so you wont notice any big changes up front. The front cover still includes a quick-reference list of modifiers, with one new addition, modifier -91 (repeat clinical diagnostic laboratory test). All modifiers are described in detail in Appendix A. The symbols used throughout the book to denote additions, revisions or other matters are the same as in 1999. New codes are indicated with the large red dot before the code number. Codes with substantial revisions have a blue triangle before the code number. The black symbols appear on either side of new and revised notes. All of the new, revised and deleted codes for 2000 are listed in Appendix B, as before.

Deleted Anesthesia Codes

Eleven anesthesia codes were deleted from CPT 2000. Most of these were consolidated into two codes in an effort to streamline reporting, Dr. Stead says. The relative values associated with the previous codes and new ones are the same, so reimbursement should not be affected. The deleted codes are listed by category below, along with the codes that should now be used instead.

- Thorax
00420Anesthesia for procedures on clavicle and scapula; not otherwise specified. To report, use 00300 (anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified).

- Pelvis (Except Hip)
01000Anesthesia for procedures on anterior integumentary system of pelvis (anterior to iliac crest), except external genitalia. To report, use 00400 (anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified).
01110Anesthesia for procedures on posterior integumentary system of pelvis (posterior to iliac crest), except perineum. To report, use 00300.

- Upper Leg (except knee)
01240Anesthesia for all procedures on integumentary system of upper leg. To report, use 00400.

- Knee and Popliteal Area
01300Anesthesia for all procedures on integumentary system of knee and/or popliteal area. To report, use 00400.

- Lower Leg (below knee, includes ankle and foot)
01460Anesthesia for all procedures on integumentary system of lower leg, ankle and foot. To report, use 00400.

- Shoulder and Axilla
01600Anesthesia for all procedures on integumentary system of shoulder and axilla. To report, use 00400.

- Upper Arm and Elbow
01700Anesthesia for all procedures on integumentary system of upper arm and elbow. To report, use 00400.

- Forearm, Wrist and Hand
01800Anesthesia for all procedures on integumentary system of forearm, wrist and hand. To report, use 00400.

- Radiological Procedures
01900Anesthesia for injection procedure for hysterosalpingography. To report, use 00952 (anesthesia for hysteroscopy and/or hysterosalpingography).
01902Anesthesia for burr hole(s) for ventriculography. To report, use 00214 (anesthesia for burr holes, including ventriculography).