Anesthesia Coding Alert

Don’t miss how joint injections and TAP blocks will be reported.

Whether you code strictly for anesthesia procedures or also for pain management, CPT® 2015 will bring numerous changes your office will need to know. Read on for the basics and we’ll share expert opinions on specifics next month.

Say Goodbye to 3 Anesthesia Codes

Only three codes from CPT®’s anesthesia section will undergo change effective Jan. 1, 2015. The new code book will delete:

• 00452 – Anesthesia for procedures on clavicle and scapula; radical surgery
  
• 00622 – Anesthesia for procedures on thoracic spine and cord; thoracolumbar sympathectomy
  
• 00634 – Anesthesia for procedures in lumbar region; chemonucleolysis.
  

Other high points that could affect your anesthesia coding include:

• Changes to joint injection codes to specify whether the physician used ultrasound guidance. The current codes (20600, 20605, and 20610) will specify “without ultrasound guidance,” and you’ll have three new codes for the same injections using US guidance.
• Four new codes for TAP (transversus abdominis plane) block that differentiate between and injection or continuous infusion and whether the provider administered a unilateral or bilateral injection.
• A new, comprehensive code for transesophageal echocardiography (TEE) monitoring that includes “real-time image acquisition and documentation, guidance with quantitative measurements, probe manipulation, interpretation, and report, including diagnostic transesophageal echocardiography and, when performed, administration of ultrasound contrast, Doppler, color flow, and 3D.” The new code will represent a more comprehensive service than the code currently allowed for anesthesiologists, 93318 (Echocardiography, transesophageal [TEE] for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing [continuous] assessment of [dynamically changing] cardiac pumping function and to therapeutic measures on an immediate time basis).

Watch for Pain Management Changes

If you also code for pain management services, you’ll be reporting kyphoplasty and percutaneous vertebroplasty services differently in 2015. Six new codes will represent the services based on the number of vertebral bodies treated and the spinal area. Each code will still represent either unilateral or bilateral injections. The biggest change is the addition of “inclusive of all imaging guidance” to the descriptors.

Because of the updated descriptors, the associated radiology codes for guidance will be deleted. You’ll no longer be able to report the following codes as part of your vertebroplasty or kyphoplasty claim:

• 72291 – Radiological supervision and interpretation, percutaneous vertebroplasty, vertebral augmentation, or sacral augmentation (sacroplasty), including cavity creation, per vertebral body or sacrum; under fluoroscopic guidance
• 72292 – … under CT guidance.
  

Spinal myelography codes also undergo changes that will help you code procedures in more detail. Existing code 62284 will be revised to represent the lumbar area rather than its current, wider range “spinal” designation. The new descriptor will read, “Injection procedure for myelography and/or computed tomography, lumbar (other than C1-C2 and posterior fossa).”

You’ll also have four new code choices for myelography via lumbar injection. Three of the codes specify spinal region (cervical, thoracic, or lumbar) and the fourth represents the procedure in two or more regions (lumbar/thoracic,cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical).