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Anesthesia Coding Alert

Reader Question:

Exam Before Fluoroscopy

Published on Mon Oct 01, 2001

Question: One of our pain management physicians performed an exam of a patients extremely painful knee under IV sedation to determine the cause of the pain. After the patient recovered from the exam, the physician performed a sympathetic block under fluoroscopy. How should the initial exam be coded?

Idaho Subscriber  
Answer: Based on whether the patient was new or established and what type of documentation you have for the procedure, you could code an appropriate E/M service. Other options include billing with 27599 (unlisted procedure, femur or knee) or 27570* (manipulation of knee joint under general anesthesia [includes application of traction or other fixation devices]) and appending modifier -52 (reduced services) because it was not performed under general anesthesia.
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