Anesthesia Coding Alert

Question: How do you charge for 67938 (removal of embedded foreign body, eyelid) with a local versus general anesthesia?

Ohio Subscriber

Answer: Your best bet would be 00300 (anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified) with modifier -52 (reduced services) for a local. Is the local considered a MAC (monitored anesthesia care) by your anesthesiologist? Medicare has the -QS modifier for MAC, but most insurance carriers do not recognize Medicare modifiers.

You should consider using modifier -23 (unusual anesthesia) for the billing since in many cases a local could be administered by the surgeon and an anesthesiologist would not be needed. The age of the patient and other factors could lead to the general anesthesia, and your physician may feel that using modifier -52 is unfair to him or her. That being the case, I would use 00300 with -23 and physical status.