Anesthesia Coding Alert

Question: How should I code for MAC (monitored anesthesia care) when one of our anesthesiologists provides it for a physician in another group to perform cervical or lumbar epidurals? The Crosswalk refers to code 02100 (Anesthesia for diagnostic or therapeutic nerve blocks and injection [when block or injection is performed by a different provider]), but it isn't in CPT.

Alabama Subscriber

Answer: Because code 02100 is not in CPT, many carriers will not accept it. Instead, several other codes are viable options for this procedure.

Code 00820 (Anesthesia for procedures on lower posterior abdominal wall) is listed as an alternative code and carries a base value of five. Code 00600 (Anesthesia for procedures on cervical spine and cord; not otherwise specified) with a base value of 10 and code 00630 (Anesthesia for procedures in lumbar region; not otherwise specified) with a base value of eight are also usually accepted. Reimbursement for this in many states can be hit-or-miss, so call the carrier in question to see which code is preferred.