Anesthesia Coding Alert

Question: Can you guide me as to how to code for multiple anesthesia services for the same patient during the same encounter?

New Mexico Subscriber

Answer: When coding and billing for multiple anesthesia services for the same patient during the same encounter, assign the most complex anesthesia procedure code with the highest base unit value, a number that represents the complexity level of anesthesia, risk to the patient, and the level of the anesthesia provider’s skills needed to perform the service. Add the anesthesia time for all procedures combined, and then divide it by the time unit increment the payer uses to determine the total units to bill on the claim form. Bill the payer for the combined dollar amount for all anesthesia services for the patient. 

When applicable, you also can include a qualifying circumstances code for complex anesthesia cases including 99100 (Anesthesia for patient of extreme age, younger than 1 year and older than 70) 99116 (Anesthesia complicated by utilization of total body hypothermia) 99135 (Anesthesia complicated by utilization of controlled hypotension) and 99140 (Anesthesia complicated by emergency conditions). Not every payer reimburses for the additional units of qualifying circumstances codes, but they help give a complete picture of the case and your provider’s work.