Anesthesia Coding Alert

Question: I'm told that I should report at least five  base units whenever a procedure is performed in the prone position. Is there an add-on code to increase base units due to positioning?

Nevada Subscriber

Answer: According to the American Society of Anesthesiologists (ASA), you should bill a minimum basic value of five - regardless of the procedure's base units - when a procedure around the head, neck, or shoulder girdle requires field avoidance or any position change other than supine or lithotomy.
 
For example, code 01260 (Anesthesia for all procedures involving veins of upper leg, including exploration) correlates to varicose vein stripping. It is a three-unit code, but the surgeon might place the patient in a prone position in order to reach the back of the leg. In that case you add two additional units and bill for a total of five base units instead of the original three.
 
You do not add additional units if the procedure has a base value of five or greater (such as 00600, Anesthesia for procedures on cervical spine and cord; not otherwise specified), because these codes already take into consideration that the patient will be prone and have higher base units to reflect it. Look for information about this in the ASA's annual Relative Value Guide.