Anesthesia Coding Alert

Question: We were asked to provide anesthesia during routine care for a patient whose diagnosis was poor intravenous access. What diagnosis codes could support medical necessity for the anesthesia?

North Carolina Subscriber

Answer: Code 459.9 (unspecified circulatory system disorder) is a good choice, mainly because it applies to many situations. Code 459.89 (other specified disorders of circulatory system; other) also might apply because it includes problems with collateral circulation, phlebosclerosis and venofibrosis. If you place a Port-a-Cath or similar device as part of a procedure, remember that many carriers prefer V codes as a secondary diagnosis if the line was placed for hydration or correction of electrolyte disturbance. In this case, you could use V58.81 (fitting and adjustment of vascular catheter) or possibly code 276.5 (volume depletion). A P3 or greater patient physical status would more strongly support using the procedure and anesthesia. Note: See Append P3-P5 Physical Status Modifiers for Reimbursement on page 20 of this issues for description of P codes.


- Sources for "Reader Questions" and "You Be the Coder" are Susan Callaway, CPC, CCS-P, an independent coding consultant and educator in North Augusta, S.C.; Barbara Johnson, CPC, MPC, an anesthesia coding professional with Loma Linda University Anesthesiology Medical Group in Loma Linda, Calif.; Scott Groudine, MD, anesthesia specialist in Latham, N.Y.; and Bev Jarvis, office manager of the physician group Anesthesiology of Marquette, PC, in Marguette, Mich.