Anesthesia Coding Alert

Question: A CRNA helps our pain management specialist on procedure days in the office. She administers anesthesia while he performs the procedure. How should I bill their services?

North Carolina Subscriber

      Answer: Report your physician's services with the appropriate procedure code, such as 64475 (Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; lumbar or sacral, single level) or 62311 (Injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; lumbar, sacral [caudal]). You will not charge for his time because he's performing flat-fee procedures.

      Submit an anesthesia code for the CRNA. Because she is working with the physician, you'll code either 01991 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; other than the prone position) or 01992 (... prone position). The patient's position during the procedure determines which code you report.

      You will charge base and time units for the CRNA. Code 01991 is worth three units plus time, and 01992 is worth five units plus time. Verify whether your carriers want you to report time units (blocks of 10 or 15 minutes) or the actual number of minutes.