Anesthesia Coding Alert
File Ketamine Infusion With 99999 and Stellar Documentation
Question: A psychiatric patient with severe depression and pain was taken to our ECT suite and was given a ketamine infusion. According to the anesthesia record the patient had a MAC while ketamine was infused for 40 minutes. It sounds like we may have been the ones to initiate the infusion as well as gave MAC. We're not sure how or what we can bill. How should we handle this? Washington Subscriber Answer: The treatment you describe is considered experimental and doesn't have associated CPT® codes for reporting purposes. Your best option could be to bill it under "Ketamine Treatment" with "dummy" CPT® code 99999 (although 99999 is not a true procedure code, it can serve as a placeholder on your claim). Include thorough documentation of the service. Another tip: Because the treatment is experimental, the patient will have to pay out-of-pocket for the service. Be sure this is thoroughly explained beforehand and have the patient sign an advance beneficiary notice (ABD) prior to treatment if you'll be filing to Medicare.
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