Question: When is it not correct to append +99116 for hypothermia?
Florida Subscriber
Answer: A few anesthesia codes already include hypothermia, which means it’s invalid to include +99116 (Anesthesia complicated by utilization of total body hypothermia [List separately in addition to code for primary anesthesia procedure]) on the claim. The distinction is easier to note with some procedures than with others.
Example 1: Hypothermia inclusion is obvious with some codes, such as 00561 (Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age). The code’s descriptor doesn’t spell it out, but the associated note does: “Do not report 00561 in conjunction with 99100, 99116, and 99135.”
Tip: Remember that for most heart cases, hypothermia is already included in the base of the anesthesia code.
Example 2: Other anesthesia codes also include hypothermia, though it’s less clear. Check out these examples:
Common, not a given: Your anesthesiologist will often induce hypothermia during intracranial surgeries to treat aneurysms, cerebral AV malformations, and other cerebrovascular procedures, but it’s not considered routine. In these cases, you can safely report +99116 in addition to the anesthesia code and may garner your physician a well-deserved boost in pay.