Anesthesia Coding Alert

The latest round of Correct Coding Initiative (CCI) edits has hit the streets, and as usual there are some developments that you will want to keep on top of. Let our experts guide you through these changes, and along the way we'll give you a quick refresher in some of the CCI edit and modifier essentials.

Remember: These edits went into effect April 1.

You won't find any anesthesia-specific additions noted for the list of mutually exclusive codes.

But don't get too comfortable -- there were two additions noted for the Column 1/Column 2 list. CPT codes 93561 (Indicator dilution studies such as dye or thermal dilution, including arterial and/or venous catheterization; with cardiac output measurement [separate procedure]) and 93562 (... subsequent measurement of cardiac output) are now bundled into most of the anesthesia services codes.

All of the anesthesia/dilution study edits have 0 modifier indicators, says Kelly Dennis, MBA, CPC, ACS-AP, with Perfect Office Solutions of Leesburg, Fla. Anytime you see a 0 modifier indicator, "there are absolutely no circumstances in which it would be acceptable to bill [93561 and 93562] with any of the anesthesia codes," Dennis says.

She also says that CCI 14.1 "listed almost all the anesthesia-codes" -- 269 in total -- in association with 93561 and 93562, including 01996 (Daily hospital management of epidural or subarachnoid continuous drug administration). Other codes that were not included were 01999 (Unlisted anesthesia procedure[s]) and "by report" codes, Dennis says.

Also bundled into most of the anesthesia services codes in CCI 14.1 is 94644 (Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour).

This edit has a 1 modifier indicator, "which indicates there may be circumstances in which it would be acceptable to bill, and an acceptable modifier will bypass the edit," Dennis says.-For 94644, CCI lists 268 anesthesia edits. This includes almost every anesthesia code; however, 01996 and 01999 are omitted from this second group.

Reality: Chances are good that you probably won't see 94644 services very often, says Scott Groudine, MD, an anesthesiologist in Albany, N.Y.