Anesthesia Coding Alert

Question:

Michigan Subscriber

Some anesthesiologists do administer controlled hypotension during certain procedures at the surgeon's request. You should code with +99135 (Anesthesia complicated by utilization of controlled hypotension [List separately in addition to code for primary anesthesia procedure]). Be sure to include the correct anesthesia code representing the surgery itself because +99135 is an add-on code. The anesthesiologist should document in the anesthesia record that the hypotension was at the surgeon's request.

Payment: Some payers won't increase the anesthesiologist's reimbursement because of hypotension unless you specify it up front. Consider negotiating for a higher dollar amount in your contracts and include documentation of the agreement with your claim.

Definition: When a chart mentions controlled hypotension, the anesthesiologist closely monitored the patient's blood pressure while it dropped drastically and then leveled off. The low blood pressure allows the surgeon to work in a virtually bloodless field.