Anesthesia Coding Alert

Question: One of our anesthesiologists encountered a patient who was very difficult to intubate and received considerable help from one of the other doctors to do a fiberoptic intubation. Can the second doctor bill for the assist?

Indiana Subscriber
 
Answer: Some carriers might pay the second physician at a reduced rate, and other carriers (such as Medicare) might not pay at all, but it's worth filing to see if you can get at least partial reimbursement for the physician's service. If you have documentation supporting the case and can justify calling it an emergency, you can bill 31500 (intubation, endotracheal, emergency procedure) with a modifier, such as -59 (distinct procedural service), to indicate that more than one physician was involved and that it was an emergency. However, if the intubation took place in the OR and was not an emergency, you would document the procedure as an intubation, 31599 (unlisted procedure, larynx), and append modifier -22 (unusual procedural services) instead. In either case, submit the claim with any documentation that supports the second physician's involvement.

 -- Answers to Reader Questions and You Be the Coder were reviewed by B.J. Horton, coding manager with Central Kentucky Anesthesia in Lexington.