Anesthesia Coding Alert

Don’t overlook the potential for extra reimbursement.

Qualifying circumstances (QC) codes represent specific situations where anesthesia services are particularly difficult. They’re reported in addition to the primary anesthesia code. You’ll find the complete list of QC codes and guidelines in the Anesthesia Guidelines of CPT^®.  

• +99100 – Anesthesia for patient of extreme age, younger than 1 year and older than 70 (List separately in addition to code for primary anesthesia procedure)
• +99116 – Anesthesia complicated by utilization of total body hypothermia (List separately in addition to code for primary anesthesia procedure)
• +99135 – Anesthesia complicated by utilization of controlled hypotension (List separately in addition to code for primary anesthesia procedure)
• +99140 – Anesthesia complicated by emergency conditions (specify) (List separately in addition to code for primary anesthesia procedure).

Remember that CPT^® classifies these as “add-on” codes, which means you must report them with another code for the main procedure.

The QC codes are essentially “added risk” codes that are inherent to the case at hand (such as emergency and age). These extraordinary risks won’t necessarily be found within the provider’s written documentation as being actually present; they exist by virtue of the condition and circumstance happening all at the same time.

One more tip: Remember that these particular add-on codes can only be reported with anesthesia services, says Kelly Dennis, MBA, ACS-AN, CAN-PC, CHCA, CPC, CPC-I, owner of Perfect Office Solutions in Leesburg, Fl. Don’t report these add-on codes with any codes from the surgery section of CPT^®.