Anesthesia Coding Alert

Question: In the 2013 ASA Crosswalk, CPT® 27759 crossed to anesthesia code 01484. In the 2014 ASA Crosswalk, it crosses to 01392 with alternate code 01480. Can you tell me why the change was made and in what instances you would use 01392 versus 01480? 

West Virginia Subscriber

Answer: 

Your first step is to understand the surgical code in question. Code 27759 (Treatment of tibial shaft fracture [with or without fibular fracture] by intramedullary implant, with or without interlocking screws and/or cerclage) describes repair of a tibial shaft fracture.  Anesthesia code 01392 (Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella) is for open procedures on upper ends of the tibia, fibula, or patella.  In comparison, the alternate Code 01480 (Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified) is for anesthesia during an open procedure on bones of the lower leg, ankle or foot. 

The old crosswalk code of 01484 (Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula) is for anesthesia during osteotomy or osteoplasty. That’s when the surgeon is cutting/removing bone or surgically repairing/altering the bone. In 27759, the surgeon is using some type of rod or other implant to stabilize the bone and reconnect the pieces. That’s very different from osteotomy or osteoplasty. 

You may have noticed that there were many orthopedic code revisions in the 2014 Crosswalk, for example Codes 27635 through 28825.  Crosswalk codes are reviewed annually and are updated for various reasons.  In this particular case, it seems that 01392 better represents the surgery than 01484 did.