Anesthesia Coding Alert

Question: Our physician administered anesthesia while another physician inserted a vertebral artery catheter. The surgical coder reported 36100 so I crossed that to 00320 for the anesthesiologist. The payer denied the claim when we submitted 00320 with Z99.11 as the primary diagnosis. What was wrong with that?

Kentucky Subscriber

Answer: You reported an incorrect anesthesia code for the procedure. Surgical code 36100 (Introduction of needle or intracatheter, carotid or vertebral artery) actually links to anesthesia code 01916 (Anesthesia for diagnostic arteriography/venography), not 00320 (Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older).

From a diagnosis perspective, Z99.11 (Dependence on respirator [ventilator] status) is not necessarily adequate as the procedure’s primary diagnosis. As ICD-10 coding guidelines state, “Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed.” Talk with your anesthesia provider or the surgeon’s coder to determine an appropriate primary diagnosis to report in addition to Z99.11.