Anesthesia Coding Alert
GI Anesthesia Might Be Allowed in New York
Question: Several of my New York clients have told me that Medicare in New York will no longer reimburse anesthesia for GI procedures (00740 and 00810) as of January 1, 2013. I’ve looked for documentation of the change, but haven’t been successful. Do you have any information on this?
Answer: As you probably know, getting reimbursed for anesthesia during GI procedures has been an issue for a number of years. Because you’re in New Jersey, be aware that Novartis has a MAC (monitored anesthesia care) policy that guides your coding. The policy includes a list of anesthesia procedures "for which anesthesia personnel provided services (MAC) are usually not needed but may be medically necessary in certain limited situations." Anesthesia codes 00740 (Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum) and 00810 (Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum) are part of the list. That shows that you can report – and be paid for – anesthesia during GI procedures, in certain circumstances.
It probably would be prudent to follow the same policy for the New York patients you code for.
New Jersey Subscriber
Anesthesia Coding Alert
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