Anesthesia Coding Alert

Question: I know to bill code 00630 for a microdisectomy procedure. The patient is in prone position, obviously. Do I bill code 01992 for the anesthesia and put the start and stop times like I did on code 00630? Is code 01992 reimbursable?

Delaware Subscriber

Answer: Yes, code 01992 (Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position) is reimbursable under normal anesthesia circumstances. However, in the procedure you describe you’re also looking at 00630 (Anesthesia for procedures in lumbar region; not otherwise specified) for anesthesia during the microdisectomy. Remember that anytime an anesthesia provider completes more than one service during an encounter, you should code according to the highest base procedure.

In your scenario, code 01992 carries five base units; code 00630 carries eight. Therefore, report code 00630 on the claim with the start and stop times for the total number of minutes.

Caveat: Also remember that many insurers have policies regarding how (or whether) to reimburse anesthesia that is administered in conjunction with pain management procedures. Check with the payer in question to determine your best coding approach.