Anesthesia Coding Alert

Question: Medicare denies our claims for conization of the cervix with a diagnosis of cervical dysplasia (622.1). I am reporting 00940 (Anesthesia for vaginal procedures [including biopsy of labia, vagina, cervix or endometrium]; not otherwise specified) for the anesthesia, along with modifier -AA (Anesthesia services performed personally by anesthesiologist).

Delaware Subscriber Answer: Surgical code 57520 (Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser) does cross to anesthesia code 00940. Some policies say you should append modifier -FP (Service provided as part of Medicaid Family Planning Program) if the procedure is for a sterilization, but your diagnosis clearly states that it's not a sterilization.

Some carriers accept 795.02 (Atypical squamous cell changes of undetermined significance favor dysplasia [ASCUS favor dysplasia]) with 57520. Try submitting this diagnosis along with a letter from the anesthesiologist explaining that the patient could not have tolerated the procedure without anesthesia.