Anesthesia Coding Alert
Confirm Anesthesia Mode With Physician
Question: I'm confused about how to report a knee manipulation with anesthesia. The anesthesiologist marked both MAC (monitored anesthesia care) and epidural on the chart. The operative report states, "Epidural with augmentation with brief intravenous general mask." What is the correct way to code this? Answer: Begin by asking your physician about the case - never just go by the operative report, especially when you aren't sure about the situation. Several coding possibilities exist, all of which will affect your coding in different ways.
Massachusetts Subscriber
If your physician used general anesthesia, base the claim on surgical code 27570 (Manipulation of knee joint under general anesthesia [includes application of traction or other fixation devices]); this crosses to anesthesia code 01380 (Anesthesia for all closed procedures on knee joint).
If the anesthesiologist administers sedation or MAC after placing a spinal or epidural, the anesthetic is the primary regional block because it's providing the majority of anesthesia for surgery. That means you'll still report 01380.
Anesthesia Coding Alert
- Check the Details:
Are You Missing Fees for Field Avoidance?
Carriers might allow extra units that boost bottom lines
A chart crosses [...] - Add It Up:
Calculate Units Correctly for Field Avoidance Pay
Accurate billing depends on identifying the correct base-unit charge
To receive correct [...] - Pain Management Focus:
Remember Modifier -50 for Bilateral Procedures
But don't forget -LT and -RT as possible options
Physicians perform many pain management procedures bilaterally, [...] - You Be the Coder:
Ask Carrier About Isovolemic Hemodilution
Question: Our anesthesiologist performed isovolemic hemodilution during a radical prostatectomy. How should I code this? [...] - Final Bilateral Checkpoint:
Documentation During Process Can Help Reimbursement
Keep track of these details
Every coder knows that even the smallest details can sometimes make [...] - READER QUESTIONS:
Intrathecal Cath Dye Study = 75809
Question: What code applies to an intrathecal catheter dye study under fluoroscopy?
Michigan Subscriber Answer: The [...] - READER QUESTIONS:
Add Modifier -53 for Failed Labor Epidural
Question: Our anesthesiologist attempted a patient's labor epidural three times. Anesthesia time began at 21:45 [...] - READER QUESTIONS:
Confirm Anesthesia Mode With Physician
Question: I'm confused about how to report a knee manipulation with anesthesia. The anesthesiologist marked [...] - READER QUESTIONS:
Watch Modifier for Return to OR
Question: How should I code a patient's return to the operating room on the same [...] - READER QUESTIONS:
Code Higher Base for Multi-CABG Procedure
Question: A patient underwent a two-vessel CABG (coronary artery bypass graft) procedure off-pump. Then she [...] - Pain-Free Payments:
Investigating Details Helps You Get Paid for Post-Op Pain Epidurals
Check these 5 areas to help claims through the process
It happens all the time - [...] - Clip-and-Save List:
Close the Door on Post-Op Claims Returns
Check these areas if they keep coming back
If your post-op pain management claims are [...] - Version 11.0 Update:
NCCI Bundles New G Codes Into Injection, Catheter Codes
Watch for these edits
National Correct Coding Initiative (NCCI) edits that went into effect Jan. 1, [...] - You Be the Coder:
Reporting a Follow-Up Consult
Question: Our anesthesiologist completed a patient's preoperative assessment before femoral bypass graft surgery under anesthesia. [...] - Correction:
Don't Report 0027T for IDET
The December 2004 issue of Pain Management Coding Alert has an error regarding the code [...] - READER QUESTIONS:
Billing an Epidural With Fluoroscopy
Question: Can we report fluoroscopy with 62311 for an epidural injection?
Washington Subscriber
Answer: This is [...] - READER QUESTIONS:
Count Diskography Levels for Reporting 72295
Question: If a physician performs diskography at C5-6, L1-2, L3-4 and L5-6, how many times [...] - READER QUESTIONS:
Charging IV Start for PCA Pump
Question: Can I report the IV start for PCA (patient-controlled anesthesia)? Our physician consulted with [...] - READER QUESTIONS:
Understand Coding TC, Fluoro With Diskography
Question: If the physician performs multiple levels of diskography, does the facility report the technical [...] - READER QUESTIONS:
Verify Diagnosis for 62311
Question: Most of our carriers consistently deny our claims with 62311. The physician marks all [...] - READER QUESTIONS:
Yes, a CRNA Can Bill 01996
Question: Can I report code 01996 for daily management of an epidural if a CRNA [...] - READER QUESTIONS:
Code With 64420 or 64421 for Post-Op Paravertebral Block
Question: Which code should I report for paravertebral blocks used for post operative pain relief [...]
