Anesthesia Coding Alert

Question: What anesthesia code should I report for an automatic implantable cardioverter/defibrillator (AICD) check? 


Nebraska Subscriber
 

Answer: For the automatic implantable cardioverter/defibrillator check, the surgeon probably reported 93642 (Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator [includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters]).

Code 00537 (Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation) is the anesthesia cross-code. Some coders believe its 10 base unit value is too high for the service rendered, so they append modifier 52 (Reduced services) and include notes explaining the anesthesiologist's work.
 
Other coders believe the anesthesiologist's risk in caring for a patient with arrhythmia justifies the high unit value. Talk with your anesthesiologist to determine what services he provided and whether appending modifier 52 is appropriate for the procedure.