Anesthesia Coding Alert
Add 99100 for Infant's Lymphatic Excision
Question: How should I report anesthesia for -excision of a cervical cystic hygroma -- lymphangioma- on a 4-month-old?
Missouri Subscriber
Answer: The surgeon will report 38550 (Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection). The corresponding anesthesia code is 00320 (Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older). This code describes the procedure well enough, but does not include infants. Consequently, most carriers or electronic submission systems will deny 00320 as an inappropriate code.
The closest code because of the patient's age is 00326 (Anesthesia for all procedures on the larynx and trachea in children less than 1 year of age). This descriptor, however, does not mention the lymphatic system, so it doesn't describe the procedure as accurately.
Because neither code is exactly correct, your best option might be to report 00320 with qualifying circumstances code +99100 (Anesthesia for patient of extreme age, under 1 year and over 70 [list separately in addition to code for primary anesthesia procedure]). Many carriers don't increase your reimbursement because of qualifying circumstances codes, but you-ll at least report the case accurately.
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