Anesthesia Coding Alert

Question: Can I bill anesthesia multiple times in a surgery? For instance, 69436 and 41520 were performed together. May I bill 00170 and 00126?

Answer: You may bill only for the highest level procedure and the total amount of time spent. Bill the procedure which has the highest ASA base units -- in this case, 00170 (Anesthesia for intraoral procedures,including biopsy; not otherwise specified), which has a base unit of five plus time. You then include the total time of both procedures.

Note: The ASA's Relative Value Guide (RVG) states that when multiple procedures are performed, other than E/M services, at the same session by the same provider,"the primary procedure or service may be reported as listed." Although you can normally identify additional procedures by appending modifier 51 (Multiple procedures), the RVG states that you cannot append 51 to codes 00100 through 01999. Using modifier 51 in this case would be incorrect.