Anesthesia Coding Alert
Figuring Base Units for Qualifying Circumstance Code 99140
Question: The Relative Value Guide states that the add-on code +99140 has a base value unit of two. My provider is billing this out at two units even though reimbursement is not figured with the anesthesia time factor. The commercial payers are reimbursing for only one unit. Should we be appealing for the second unit? Or should we only be billing for one unit in the first place? Missouri Subscriber Answer: Code +99140 (Anesthesia complicated by emergency conditions [specify] [List separately in addition to code for primary anesthesia procedure]) has a base value of two, but should be billed with "1" as the quantity because all anesthesia add-on codes are billed as oneunit. Although the add-on code might be valued at more than one base unit, that is calculated when priced by the payer (whatever the contracted rate is). Some payers don't pay extra for physical status modifiers or extenuating circumstances codes such as +99140. Your billing software might automatically apply the fee that would be calculated for the two base units, but the payer will reimburse based on the contracted rate for that code.
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