Anesthesia Coding Alert

Question: One of our anesthesiologists is asking if a pre-op history and physical might be separately reimbursable on the same day of the procedure. He is being asked to perform this since podiatry practitioners do not have the training or qualifications to perform a complete history and physical in his state. The anesthesiologist believes he should be able to receive separate reimbursement for this since it is over and above the normal pre-exam he would perform for any other type of case. Would it be appropriate for us to add modifier 22 to the claim with the necessary documents requesting one additional unit of service for the H&P?

Arizona Subscriber

Answer: No, this is not an appropriate way to report the service. The patient’s pre-anesthesia assessment is included in the base value for all anesthesia services provided, which means under no circumstances can additional time be added to capture units related to pre-operative work. Although your physician believes he should be able to receive separate payment, you shouldn’t bill the service separately unless he specifically contracts with an insurer for separate payment.