Anesthesia Coding Alert

Question: Is special care for hypothermia included in anesthesia codes?

Ohio Subscriber

Answer: Hypothermia inclusion is obvious with some anesthesia codes, such as 00561 (Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age). The code’s descriptor doesn’t spell it out, but the associated note does: “Do not report 00561 in conjunction with 99100, 99116, and 99135.”

Other anesthesia codes also include hypothermia, though it’s less clear.

For example, you can’t report +99116 (Anesthesia complicated by utilization of total body hypothermia [List separately in addition to code for primary anesthesia procedure]) with 00562 (... with pump oxygenator, age 1 year or older, for all non-coronary bypass procedures [e.g., valve procedures]) or for reoperation for coronary bypass more than one month after the original operation; the key terminology in the descriptor is “with pump oxygenator.”

Explanation: When your anesthesiologist uses a pump oxygenator during cardiac surgery, no blood circulates through the coronary arteries. Therefore, the myocardium (or heart muscle) is ischemic (meaning there is restricted blood supply). Hypothermia is a routine part of the procedure to help protect the heart from ischemic injury.

Also, steer clear of reporting +99116 with 00563 (... with pump oxygenator with hypothermic circulatory arrest). The mention of a pump oxygenator sends you away from +99116, as does the hypothermic circulatory arrest. Your anesthesiologist induces hypothermic circulatory arrest to significantly slow cellular activity levels and stop blood circulation. Bringing the patient to that state allows the surgeon to safely complete procedures when he can’t use clamps to contain the blood flow.