Anesthesia Coding Alert

Question: What is the best code for anesthesia during IVC (inferior vena cava) filter insertion? I've seen several options and don't know how to decide.


Massachusetts Subscriber

Answer: The surgical code for IVC filter insertion is 37620 (Interruption, partial or complete, of inferior vena cava by suture, ligation, plication, clip, extravascular, intravascular [umbrella device]). This code correlates with several anesthesia codes, depending on the circumstances. The primary cross-code is 01930 (Anesthesia for therapeutic interventional radiologic procedures involving the venous/lymphatic system [not to include access to the central circulation]; not otherwise specified), with an alternative code of 00882 (Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation).

Refer to the surgeon's specialty and the surgical technique when you're determining which anesthesia code to use. If the physician performs the procedure percutaneously via the jugular or femoral vein, report 01930 for the femoral approach or 01932 (... intrathoracic or jugular) for the jugular approach (although the intrathoracic/jugular approach is not as common).

If a vascular surgeon performs the procedure with an open incision, report 00882 because this technique is more in-depth than the interventional radiology approach; you'll select this code most often for IVC filter insertion.

The three anesthesia codes have different base values: 01930 is 5 units, 01932 is 7, units and 00882 is 10 units. Talk with the physician about which code is most appropriate, and document the reasoning for it.