Anesthesia Coding Alert

Reader Question:

Know When to Use Interventional Radiology Codes

Question: The coders in other departments select the appropriate surgical codes before sending information to us in anesthesiology. I am concerned about some urology codes I receive, such as a case with 52260, 52204 and 74420. Codes 52260 (Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction [spinal] anesthesia) and 52204 (Cystourethroscopy, with biopsy) are both 3-unit codes. 74420 is the highest-base procedure (seven units), but doesn't seem quite right because it's a radiology code. What should I do? New Jersey Subscriber Answer: In this situation, the physician performed a urology procedure, and the radiology code reflects when the urologist read the radiology results. If you know that the procedure required interventional radiology, coding the anesthesia based on 74420 (Urography, retrograde, with or without KUB) would be appropriate. Otherwise, use the urology codes to determine the appropriate anesthesia codes, such as 00910, Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified, for the urology codes in your example. You Be the Coder and Reader Questions were provided by Bea Olsen, CPC, owner of Integrity Healthcare Consulting in Phoenix.  
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