Anesthesia Coding Alert

Question: One of our new anesthesiology clients works in an eye center. He says that he only administers blocks – no general anesthesia – for the eye surgeries. Should we use a code from range 00140-00148 or a codesuch as 64400 for his services?

Oregon Subscriber

Answer: Assuming the anesthesiologist is acting asthe anesthetist for the eye surgery and is not the provider performing the actual eye surgery, and that his primary anesthesia technique for all eye procedures is a bulbarblock instead » of general anesthesia to anesthetize his patients, then the prime anesthesia technique is a block.

If your anesthesiologist only does the block and nothing else, he is providing a surgical service: either 64400 (Injection, anesthetic agent; trigeminal nerve, any division or branch) or 67500 (Retrobulbar injection; medication [separate procedure, does not include supply of medication]).

If he does the block and anesthesia, he can bill the time for the block and all thetime plus base value for the procedure 00142 (Anesthesia for procedures on eye; lens surgery) if the surgery is for a cataract, but cannot bill for the actual block as it is the mode of anesthesia.

The American Society of Anesthesiologists (ASA) code assigned to the actual anesthesia service depends on the type of procedure being performed. For example, a cataract extraction would be coded by CPT^® as 66984 (Extracapsular cataract removal with insertion of intraocular lens prosthesis [1 stage procedure], manual or mechanical technique [e.g., irrigation and aspiration or phacoemulsification]) and crosswalk to ASA 00142.

Count your units: ASA 00142 is valued at 4 base units. You will need to know the anesthesia start and stop times to determine your anesthesia charge, using the formula base units plus time, multiplied by conversion factor.

Always verify the procedures your anesthesiologist performs to verify what he means in his documentation.