Anesthesia Coding Alert

Question: Can you help clarify anesthesia codes CPT 00752 (Anesthesia for hernia repairs in upper abdomen; lumbar and ventral [incisional] hernias and/or wound dehiscence) and 00832 (Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernia)? The surgical codes related to these (49560-49566, codes related to repair of incisional or ventral hernia) crosswalk only to 00832. Code 00752 is not listed as an alternative anesthesia code; instead, the Crosswalk says only lumbar hernias or wound dehiscence qualifies for 00752. Why is the wording different for the two anesthesia codes? It appears that the only difference is whether the procedure is for the upper or lower abdomen, so why are they worded differently?

Nebraska Subscriber

Answer: You are right in thinking that the only difference between the codes you list is the location. The code groups are split according to site (00700-00797 for upper, and 00800-00882 for lower abdomen), probably because hernias can occur in either area, but the unit values are the same (6 units plus time). Since anesthesia coding is based on reporting codes from the most appropriate body region that satisfies the clinical condition, codes for each area are needed even if they seem virtually the same. Unless you see an operative report indicating an upper abdomen incision or the anesthesiologist specifies the hernia's location, you will probably code with 00832 in most instances.