Anesthesia Coding Alert

Question: Which anesthesia code should I report for a pericardial window created for pericardial effusion?

Maine Subscriber
 
Answer: Code CPT 33025 (Creation of pericardial window or partial resection for drainage) is the surgical code for creating a pericardial window for drainage. The first crossover code for 33025 in the ASA Crosswalk is 00790 (Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified) with alternate code 00560 (Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator).
 
When coding for this service, consider whether the surgeon used an abdominal approach or opened the patient's chest. Most surgeons use an abdominal approach, which you should report with 00790. Consider reporting 00560 if the surgeon opens the chest.
 
Code 00790 may be more appropriate in terms of its base units (seven), but some coders believe that 00560 is more accurate because this procedure is for the pericardial/pericardium area instead of an intraperitoneal or upper-abdomen procedure. The 15 base units for 00560 is high for creating a pericardial window. So if you choose to report 00560, append modifier -52 (Reduced services) and adjust the base units to a more appropriate level (some coders recommend 10 units for this scenario).

 - You Be the Coder and Reader Questions were answered by Sharon Ryan, CPC, anesthesia coder with Anaesthesia Associates of Massachusetts PC, in Westwood, Mass.