Anesthesia Coding Alert

Question: An emergency hysterectomy patient was taken to recovery, where bleeding continued. The anesthesiologist stayed with the patient and continued charting in recovery and straight through a return to the operating room for exploratory laparotomy on the same record. Should this have been billed together or as two separate procedures?

Tennessee Subscriber

Answer: If your doctor was in constant attendance with the patient, the anesthesia time did not end until after the second procedure was completed. File a paper claim and include a copy of the patients reports, coding with 00840 (anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified) because the hysterectomy was the original procedure and modifier -22 (unusual procedural services). Be sure to include thorough documentation showing that the physician was in constant attendance so the continuous time can be reimbursed appropriately.