Anesthesia Coding Alert

The October update to the 2009 Medicare Physician Fee Schedule (MPFS) database included good news for anesthesiologists: an increase in practice expense relative value units (RVUs) for 93503 (Insertion and placement of flow directed catheter [e.g., Swan-Ganz] for monitoring purposes).

The increase applies only when your anesthesiologist places the Swan-Ganz for monitoring purposes in a facility setting, but don't let that bother you. "A Swan-Ganz catheter placement is a highly invasive procedure usually performed for patients requiring intensive care," says Scott Groudine, MD, professor of anesthesiology at Albany Medical Center in New York. "A facility setting would be the only appropriate location."

The change went into effect Oct. 5 and bumped the RVUs from 0.00 to 0.75. That means reimbursement of $139.23 for 93503, an increase of approximately $27.05  before geographic adjustments). CMS says the change is effective for services provided on and after Jan. 1, 2009.

Next steps: Getting the extra reimbursement is up to you, because payers are not required to review their files and pay past claims. CMS has instructed payers to adjust claims that are brought to their attention,  however, so sift through your records and refile accordingly.

Information: Read the transmittal at www.cms.hhs.gov/Transmittals/downloads/R1810CP.pdf.