Anesthesia Coding Alert

Question: What is the best anesthesia code for a laparoscopic vaginal hysterectomy? The ASA Crosswalk lists both 00840 and 00944.

New Jersey Subscriber

Answer: Both anesthesia codes 00840 (Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified) and 00944 (Anesthesia for vaginal procedures [including biopsy of labia, vagina, cervix or endometrium]; vaginal hysterectomy) can be acceptable, and both have a base unit value of 6. Note, however, that 00944 specifies a vaginal hysterectomy.

Some coders recommend using 00840 if the surgeon completes any other procedure at the same time as the hysterectomy or if he uses an abdominal approach. If the hysterectomy is the only procedure performed or if it's strictly vaginal, 00944 might seem more appropriate.

The related surgical codes that you're crossing from are:

• 58550 – Laparoscopy, surgical, with vaginal hyster­ectomy, for uterus 250 g or less
• 58552 – Laparoscopy, surgical, with vaginal hyster­ectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)
• 58553 – Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g
• 58554 – ... with removal of tube(s) and/or ovary(s).