Advanced Search

Anesthesia Coding Alert

Reader Question:

Payer Dictates Propofol With Endoscopic Procedures

Published on Mon Jul 09, 2012

Question: Is Propofol separately reimbursable with endoscopic procedures, or is it bundled into the procedure charge? Does this vary between Medicare and commercial insurances?Mississippi Subscriber Answer: Anesthesiologists normally bill professional fees and the facility bills for any medications. Correct Coding Initiative (CCI) edits don't bundle the procedure and medication, but the Propofol is classified as "Status code E: Excluded from Physician Fee Schedule by regulation." Payers that follow CCI probably won't pay separately for the Propofol, but you can check with each of your insurers to learn whether their stance varies.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Anesthesia Coding Alert

View All