Anesthesia Coding Alert
Don't Try to Bill Anesthesia for Fetus During Mom's Surgery
Question: An expectant mother was given general anesthesia during a procedure. The fetus (28 weeks in-utero) was given a weight-based cocktail of fentanyl, vecuronium, and atropine. Anesthesia time for the mother was 1048 to 1429; anesthesia time for the fetus was 1145 to 1405. Two anesthesiologists were involved in the case. Can we bill for anesthesia for the fetus? Nevada Subscriber Answer: No, you cannot bill anything for the fetus separately because the insurance companies won’t cover a baby as a separate member on the policy until after the birth. You’d have to bill both charges to the mother’s policy, one of which would likely be denied as a duplicate. Since it’s a unique situation, you may be able to appeal with notes and an explanation for the multiple services and get payment for both physician’s services.
Related Articles
Anesthesia Coding Alert
- Anesthesia Basics:
Don't Get Muddled Over Moderate Sedation Coding
Keep 4 things in mind when deciding whether you can report the service. Hearing multiple [...] - Code Corner:
Choose from These Codes When Reporting Moderate Sedation
Caveat: Have clear documentation that the codes apply. CPT® 2019 includes six codes for moderate [...] - Procedure Focus:
Are You Up to Date on TPI Coding? Find Out Before It's Too Late
Plus: Keep this list of potential associated diagnoses handy. Even if you don’t code for [...] - Technology News:
CMS Makes a Move to Close Communication Gaps
Here’s the scoop on the newest way to share data. The Centers for Medicare & [...] - You Be the Coder:
Submit This Code for Axillary Sentinel Node Biopsy
Question: The surgeon performed an axilliary sentinel node biopsy in conjunction with a partial mastectomy. Which [...] - Reader Question:
Begin With 36902 to Cross to Anesthesia for Dialysis Circuit
Question: What is the correct way to code for anesthesia related to angioplasty on a dialysis [...] - Reader Question:
'Unlisted' Is Your Option for Anesthesia During Nasogastric Tube Placement
Question: I bill for a children’s hospital and a small child was brought to the [...] - Reader Question:
Remember That 62263 Covers Multiple Days of Treatment
Question: My physician performed an epidural lysis and administered three injections over the course of [...] - Reader Question:
Choose Correctly Between Modifiers QY and QX
Question: I’m coding for a procedure that included an anesthesiologist and CRNA. Can you clarify [...] - Reader Question:
Don't Try to Bill Anesthesia for Fetus During Mom's Surgery
Question: An expectant mother was given general anesthesia during a procedure. The fetus (28 weeks [...] - Reader Question:
Append Modifier 23 to Explain Unusual Anesthesia
Question: A patient needed general anesthesia during an EEG due to behavioral issues and autism. [...]
