Anesthesia Coding Alert

Question: What guidelines should I follow when reporting +99100 for a patient of extreme age?

Kentucky Subscriber

Answer: You should submit qualifying circumstances code +99100 (Anesthesia for patient of extreme age, younger than 1 year and older than 70 [list separately in addition to code for primary anesthesia procedure]) only in certain age-related situations. Report it along with the appropriate anesthesia procedure code when your physician or CRNA works with an infant under one year of age or an adult older than 70 years of age.  

Also consider: Coders sometimes debate exactly what “older than 70” means. Some recommend only reporting +99100 for patients who are 71 years of age or older, not patients in the year following their seventieth birthday. Other coders believe that +99100 is applicable once the patient turns 70. There’s no solid documentation verifying once stance versus the other, so either interpretation can be justified as long as the payer doesn’t have a more specific guideline.

Two  more  tips: Remember that traditional Medicare does not pay additional amounts for qualifying circumstances codes such as +99100. In addition, some anesthesia codes already include units to account for the “age qualifier,” such as 00326 (Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age).