Anesthesia Coding Alert

Question: Some of our coders report 01630 for anesthesia associated with 29827 and 29828. I read the descriptor for 01630 as pertaining to the humeral head and neck and shoulder joints instead of only tendons. Would 01610 be more appropriate? 

Iowa Subscriber

Answer: According to the 2014 ASA Crosswalk, the other coders in your office are correct. 01630 (Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified) is the applicable anesthesia code for both 29827 (Arthroscopy, shoulder, surgical; with rotator cuff repair) or 29828 (…biceps tenodesis). Code 01630 has a base unit value of 5. 

You might have considered 01610 (Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla) because it also involves the shoulder area. There are often cases when more than one anesthesia code might be appropriate, which is why it’s important to consider the base values if they’re different for each code. The base value for 01610 and 01630 is the same (5), but an auditor reviewing your charts would expect to see 01630 as suggested in the Crosswalk. 

Input: The Crosswalk includes a form at the front of the book for any suggestions regarding code changes and rationale. For this year, suggestions must be sent in by June 1, 2014, in order to be reviewed for the 2015 Crosswalk.