Anesthesia Coding Alert

Question: Which code should I use for an orthotripsy (the ablation of a heel spur using laser)?

California Subscriber

 
Answer: Some physicians report it with 28899 (unlisted procedure, foot or toes), but 20979 (low intensity ultrasound stimulation to aid bone healing, noninvasive [nonoperative]) could also be appropriate. Ask your carriers if they require crossing the surgical codes to anesthesia codes. If so, 28899 becomes anesthesia code 01480 (anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified). The 2001 Crosswalk states that 20979 is performed without anesthesia, so the procedure code would be reported instead of a corresponding anesthesia code if the carrier accepts it. However, sometimes anesthesia is necessary even if the surgical code states that it is not, such as 20979. In that case, use 01462 (anesthesia for all closed procedures on lower leg, ankle, and foot) and modifier -23 (unusual anesthesia) if you have adequate documentation for the need of anesthesia.