Anesthesia Coding Alert

Question: The Anesthesia Crosswalk crosses CPT^® code 58550 to 00944, with 00840 as an alternate. What determines whether you use 00944 or 00840?

Oklahoma Subscriber

Answer: Since anesthesia codes are based on anatomic location, you first need to check the provider’s notes from the procedure to see where and how it was performed.

You’re coding anesthesia for a laparoscopic vaginal hysterectomy (58550, Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less). The most likely scenario is that the surgeon performed the procedure through the vagina, in which case you would use 00944 (Anesthesia for vaginal procedures [including biopsy of labia, vagina, cervix or endometrium]; vaginal hysterectomy), with a base value of six.

Alternative: In the unlikely event that the surgeon reached the vaginal cuff through an abdominal approach, you would report 00840 (Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified) for intraperitoneal anesthesia. This code also has a base value of six units.

Bottom line: Because both 00944 and 00840 each carry six base units, your anesthesiologist’s reimbursement will be the same for either code. However, you want to always report the code that most accurately describes the service rendered, so double check the surgeon’s record to determine the approach and, therefore, the correct anesthesia code.