Anesthesia Coding Alert

Question: I have recently had some discussion with our office administrator about why we are not billing anesthesia consults for our CRNA. I would use an E/M code for the consult with a pre-procedural ICD-10 diagnosis. Would this be appropriate? Also, does any ASC ever include (build in) an anesthesia charge with their surgeries? To me, this is strange.

Connecticut Subscriber

Answer: Reporting an E/M code for evaluation of the patient prior to anesthesia would not be appropriate. According to both CPT^® and CMS/NCCI guidelines, the codes for anesthesia service already include pre- and post-anesthesia care by the provider.

In addition, evaluation of a patient prior to anesthesia does not meet the definition of a consult (which basically is another provider’s request for a specialist’s opinion about how to treat a patient’s particular problem). A CRNA can provide and bill a consult if he or she is requested to perform one, but you cannot bill a consult for routine pre-procedural work.

ASC billing includes only facility charges, not professional. The facility’s cost for the anesthesia would in fact be included in the ASC’s surgical procedure rate, but the professional charges for anesthesia would not be. These are two different things.