Anesthesia Coding Alert

Question: What are the anesthesia code and base units for extracorporeal shock wave therapy (ESW) involving plantar fascia? Should I report 0020T (Extracorporeal shock wave therapy; involving plantar fascia)?

New Mexico Subscriber
 
Answer: Report 0020T if the carrier still requires surgical CPT codes. If you may report an anesthesia code, use 01462 (Anesthesia for all closed procedures on lower leg, ankle, and foot), if the physician performed the ESW as a closed procedure.
 
Two other anesthesia codes mention extracorporeal shock wave therapy: 00872 (Anesthesia for lithotripsy, extracorporeal shock wave; with water bath) and 00873 (... without water bath). These are not appropriate for this situation since they are in the lower-abdomen code section and their base units are too high for the area involved in your case. Code 01462 is three base units, which is more appropriate. In the rare case of an open procedure, report 01480 (Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified).
 
If you do report 0020T, remember that this is a Category III tracking code, and Medicare does not usually pay for tracking codes. Some LMRP guidelines (such as one from Riverbend Government Benefits Administrator) state that the physician should use sedation or a local anesthetic for the procedure instead of general anesthesia, so they don't reimburse for general anesthesia.