Watch 3 areas before expecting 2 extra units for emergency reporting. Reporting any qualifying circumstances (QC) codes for anesthesia can be tricky, but knowing when to classify a situation as a true emergency can be a real challenge unless you're well-versed in the emergency conditions guidelines. Check coding definitions and your provider's documentation to know whether you can legitimately add two extra units for +99140 (Anesthesia complicated by emergency conditions [specify] [List separately in addition to code for primary anesthesia procedure]) to your claim. Clarify Your 'Emergency' Definition CPT includes a note with +99140 stating that "an emergency is defined as existing when delay in treatment of the patient would lead to a significant increase in the threat to life or body parts." Your key to knowing a case meets emergency conditions lies in your anesthesiologist's notes. "Quite a number of cases come in where the anesthesiologist marks 'emergency' but many times the 'emergency' isn't all that clear," says Leslie Johnson, CCS-P, CPC, director of coding and education for Medi-Corp., Inc., of New Jersey. Documentation supporting an emergency will depend on each case, so read the chart thoroughly when your provider indicates an emergency. Solution: "An OB patient who comes in for a cesarean section isn't automatically an emergency," explains Scott Groudine, M.D., professor of anesthesiology at Albany Medical Center in New York. "However, a diagnosis of fetal distress and prolapsed cord virtually always implies an emergency that can't wait." Under these circumstances, you could be justified in reporting +99140. Remember 'Unexpected' Doesn't Equal 'Emergency' Some physicians tend to add "emergency" to unexpected events, such as after hours or weekend cases they get called to attend. Timing alone isn't enough to merit +99140, according to the Relative Value Guide (RVG). Remember: Example: Follow the Payer's Guidelines Even if a case qualifies as an emergency, check the payer in question's guidelines before automatically including +99140. Not every payer (including Medicare) recognizes qualifying circumstances codes or pays additional units for their use. But for payers that reimburse, you can add two base units to the claim. Tip: