Anesthesia Coding Alert
Negotiate with Private Payers Before Submitting 95955 with Anesthesia Code
Question: Some anesthesiologists in our area are billing 95955 in addition to the procedure and getting paid for both codes. I always thought 95955 was an integral part of the anesthesia and not separately billable. Can we report it with the anesthesia code? Utah Subscriber Answer: You are correct in saying that Correct Coding Initiative (CCI) edits consider 95955 (Electroencephalogram (EEG) during nonintracranial surgery (eg, carotid surgery)) an integral part of the anesthesia service. The American Society of Anesthesiologists also does not support billing 95955 when providing anesthesia because the physician uses the EEG for “noninvasive monitoring.” Medicare and some other payers also do not separately reimburse 95955. Caveat: Don’t give up hope. Some payers do not follow CCI, so a physician group might make contractual arrangements with an insurer to reimburse the service separately. Because of this, check whether your payer adheres to CCI guidelines to determine whether to report 95955.
Related Articles
Anesthesia Coding Alert
- Anesthesia Basics:
Refresh Your Time Calculation Savvy With These 3 Scenarios
Remember every unit is critical to anesthesia claims success. Time calculation is an integral part [...] - Coding Update:
Get Ready for New CPT® Codes That Could Change Your Reporting in 2020
Tip: Pay special attention if you sometimes report pain management services. Fall is here, and [...] - Compliance:
Prepare for Stricter Medicare Provider Enrollment, Thanks to New Rule
CMS will have greater authority to deny or revoke enrollment. The trend toward deregulation in [...] - You Be the Coder:
Here's How to Bill Your Teaching Physician's Service
Question: We currently have a medical student working with us at our clinic. In patient [...] - Reader Question:
Append Modifier QZ for CRNA Without Medical Direction
Question: Our facility does not have an anesthesiologist on staff so relies on CRNAs. A [...] - Reader Question:
Turn to E/M Codes in Certain Scenarios Before Induction
Question: A patient with a stab wound to the right chest wall (with hemopneumothorax) was [...] - Reader Question:
Include Clear Documentation of Anesthesia During Extubation
Question: Is it possible to charge for an extubation procedure? The surgeon did the extubation, [...] - Reader Question:
Negotiate with Private Payers Before Submitting 95955 with Anesthesia Code
Question: Some anesthesiologists in our area are billing 95955 in addition to the procedure and [...] - Reader Question:
Only Report Z99.11 as a Secondary Diagnosis
Question: Our physician provided anesthesia while another physician inserted a vertebral artery catheter (36100). The [...] - Reader Question:
Cardiac Bypass Anesthesia Includes +99116 and +99135
Question: Can we code for induced hypothermia and hypotension in addition to anesthesia during a [...] - Reader Question:
C-section and Bowel Repair During Same Session
Question: A patient went to the OR for a C-section due to bowel obstruction. Can [...]
