Anesthesia Coding Alert

Question: Can our anesthesiologist at the surgical center receive reimbursement when he administers IV sedation during lumbar injections (the pain specialist from another group administered the injection)? If so, which  code should we report? The conscious sedation codes don't seem appropriate, but I haven't found any direct crosswalks for the spine procedures


Oregon Subscriber

Answer: You-re correct about the conscious sedation codes (99141, Sedation with or without analgesia [conscious sedation]; intravenous, intramuscular or inhalation; and 99142, - oral, rectal and/or intranasal) not being appropriate. Because the anesthesiologist only administered sedation and did not perform the injections, you should bill it as an anesthesia service.

The most common codes for this are 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) and 01992 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; prone position). Charge three units plus time for 01991 or five units plus time for 01992, depending on the patient's position.
 
Include any diagnosis that supports medical necessity for the anesthesia (such as cardiac problems, Parkinson's disease and mentally unstable conditions), and be sure you report a type-of-service 7 for anesthesia.