Anesthesia Coding Alert

Question: A child was brought into the operating room with upper respiratory distress and was anesthetized by the anesthesiologist. An otolaryngologist was on standby in case the emergency intubation failed and an emergency tracheotomy was required, but the anesthesiologist successfully intubated the child. Which anesthesia code would be most appropriate for this situation? Code 31500 (Intubation, endotracheal, emergency procedure) seems inappropriate because it does not allow the time involved to be billed.

Florida Subscriber

Answer: If the physician did not perform a diagnostic laryngoscopy or other service while the child was in the operating room, your best option is to bill the intubation with 31500 and append modifier -23 (Unusual anesthesia). This is assuming that the anesthesiologist performed the intubation. If another provider intubated the patient, bill 31500 with modifier -22 (Unusual procedural services). You should have the anesthesiologist dictate a thorough report to attach with the claim.