Anesthesia Coding Alert
Can Coders Override ASA CROSSWALK® Options?
Question: Can you explain why for AV fistula repair code 35190 the ASA CROSSWALK® doesn’t list upper leg anesthesia code 01270? I’ve checked with the surgeon and reviewed the op report; the listed code and alternate code suggestions don’t fit. North Carolina Subscriber Answer: The American Society of Anesthesiologists (ASA) CROSSWALK® is intended as a guide but may not offer all applicable codes. Note, the third paragraph of the Introduction section of the 2023 ASA CROSSWALK® (page vi) indicates, “the listing of a CPT procedure code with a CPT anesthesia code does not limit or restrict use of an alternate or unlisted code.” Bottom line: Your coder knowledge is allowed to override the suggested code(s) and guide selection of an anesthesia code that more accurately represents the anesthesia service. Don’t miss: The CROSSWALK® comment under 35190 (Repair, acquired or traumatic arteriovenous fistula; extremities) indicates, “Selection of either the primary anesthesia code or of an alternate is determined by the site of the surgical procedure.” This is further proof that it is acceptable for coders to look under the surgical procedure’s anatomical site. So, submit 01270 (Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified) if you think it’s the best code to describe the circumstances. You can email a proposed change form to the ASA at CROSSWALK@asahq.org. If the committee agrees the code is an appropriate choice, they may add it to the listed selection of alternate codes.
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Can Coders Override ASA CROSSWALK® Options?
Question: Can you explain why for AV fistula repair code 35190 the ASA CROSSWALK® doesn’t list [...]
