Anesthesia Coding Alert

Question: A patient came to our emergency department with severe abdominal pain. The attending physician diagnosed it as appendicitis, and considered it an emergency case. Yet the patient had been admitted and was in observation for 40 minutes before surgery occurred. Can I use +99140 for this?

Alabama Subscriber

Answer: Code with 99140 (Anesthesia complicated by emergency conditions [specify] [List separately in addition to code for primary anesthesia procedure]). 99140 is one of four add-on codes which describe qualifying circumstances (QC). These cover complicating factors that can change how your anesthesiologist cares for a patient:

The CPT manual makes a note in its description of 99140 defining an emergency as "existing when delay in treatment of the patient would lead to a significant increase in the threat to life or body parts."

There are times when your anesthesiologist will report a case as an emergency because the patient was admitted via the emergency department (ED).

If you are unsure about the details of the case, or whether your anesthesiologist is simply reporting where the patient came in, have a talk with him to discuss details of the encounter and identify any diagnosis.

For +99140 as well as other QC codes, consider that you will add one, two, or five extra units to your procedure code, depending on which code applies.

Tip: Never report QC codes without the primary anesthesia procedure code, such as 00840 (Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified).