Anesthesia Coding Alert

Question: Our anesthesiologist used a pump oxygenator during a coronary artery bypass graft (CABG). How should I code for this?

Montana Subscriber

Answer: Because your anesthesiologist used the pump oxygenator, you'll report 00562 (Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator). If he had performed the procedure without the oxygenator, you would report 00566 (Anesthesia for direct coronary artery bypass grafting without pump oxygenator) instead.

Difference:  Most physicians use the pump oxygenator during CABG cases. However, some opt to complete the procedure without this device, usually when the procedure is a single or double bypass.

You should always be able to find notes regarding whether your anesthesiologist used the pump oxygenator during the procedure, especially when the procedure is completed off-pump. Make sure that you remind your physicians of the necessity of clear documentation. This is especially important in cases such as CABG, because the off-pump code (00566) carries five more base units than the on-pump code (00562).