Anesthesia Coding Alert

Question: Our anesthesiologists sometimes lower a patient's body temperature to 32 degrees Celsius, or even 22 C or 18 C. What guidelines should I follow before reporting hypothermia for a case?

Texas Subscriber

Answer: Anesthesia providers often lower a patient's body temperature during a procedure, but not to hypothermic levels. Most carrier guidelines recommend that the patient's body temperature be lowered below 20 degrees Celsius before you can classify it as hypothermia.
 
CPT only includes one anesthesia code for hypothermia: 00563 (Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest). It is a 25-base-unit procedure.
 
Note: 00563 is a circulatory arrest code, not a bypass code. Do not report 00563 for routine bypass cases involving hypothermia.
 
Many insurance carriers -- including Medicare -- do not reimburse for induced hypothermia. Check your carrier's policy before expecting additional reimbursement for hypothermia.