Anesthesia Coding Alert
Include Details for Post-Op Epidural
Question: Should I code daily management of a post-operative epidural differently if a CRNA performs it? What other details should I include? Answer: You should code the service the same, regardless of whether a CRNA or anesthesiologist performs it. If you treat a Medicare patient, be sure to include the correct modifier indicating the physician's role - probably modifier -QZ (CRNA service: without medical direction by a physician). The base code for epidural management is 01996 (Daily hospital management of epidural or subarachnoid continuous drug administration), at three base units (though this is only for follow-up days, not the day the CRNA places the catheter).
Vermont Subscriber
List the postoperative diagnosis as the primary diagnosis (usually the site of pain) and include V58.49 (Other specified aftercare following surgery) as the secondary diagnosis. Also, be sure to report type of service (TOS) 01 (Medical service) instead of the usual TOS 07 (Anesthesia service). Some carriers might also request that you note "Daily management of continuous epidural drug administration" in Box 19 of the CMS-1500 form.
Anesthesia Coding Alert
- Modifier Know-How:
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Check Diagnosis Code for Postpartum D&C
Question: Medicaid denies our claim for a case involving a D&C due to postpartum bleeding. [...] - Pain Management Focus:
Clearly Document Post-Op Pain Relief for 01996 Payments
These 3 steps lead to success The fees for global anesthesia codes include most of [...] - Reader Questions:
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Question: Can we code for conscious sedation during pain management procedures? If so, should we [...] - Reader Questions:
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Question: Our physician provided anesthesia during a CT-guided liver biopsy. The procedure code crosses to [...] - Reader Questions:
Report 1 Code for Multiple Procedures
Question: Our physician provided anesthesia for periprosthetic capsulectomy of the breast. Should I append modifier [...] - Reader Questions:
64999 May Be Best for New On-Q Pain Pump
Question: What code should I report for the new On-Q pain pump?
Michigan Subscriber Answer: [...] - Reader Questions:
It's OK to Change EVLT Code
Question: Our physician performed anesthesia during endovenous laser treatment (EVLT) on the lower leg. The [...] - Reader Questions:
Watch NCCI Edits for Pump Refills
Question: Medicare denies our claims for reprogramming and refilling an implantable pump, saying that the [...] - Modifiers Make a Difference:
Performing 2 Services on the Same Date? Pick From These 3 Modifiers
Documentation explains the story, increases specificity Every coder knows that appending modifiers can help you [...] - Details Count:
Follow Strict Guidelines to Collect Modifier -25 Pay
These 3 checkpoints can help your Medicare claims Your pain management specialist conducted an E/M [...] - Carrier Update:
BC/BS Montana Adds Payable Diagnoses to Tendon Injections
Check your carriers' diagnosis code listings to ensure accuracy You're coding for accuracy, not for [...] - News You Can Use:
Watch Out for New ICD-9 Codes, Fluoro Guidelines
Upcoming changes - and retroactive ones - make a difference Expect an easy transition [...] - You Be the Coder:
Cryoablation for Neurolysis
Question: How should I code bilateral occipital neurolysis with cryoablation? Also, how should I code [...] - Reader Questions:
Purpose Dictates Regional Bretylium Block Code
Question: How should I code an extremity IV regional bretylium block for reflex sympathetic dystrophy?
Indiana [...] - Reader Questions:
Include Details for Post-Op Epidural
Question: Should I code daily management of a post-operative epidural differently if a CRNA performs [...] - Reader Questions:
Use 64517 for Superior Hypogastric Block
Question: Our physician performed a superior hypogastric nerve block procedure using two needles. How should [...] - Reader Questions:
Check With Carrier on 01991 and 01992
Question: We have some problems collecting payment when we report anesthesia services during a diagnostic [...] - Reader Questions:
Verify Diagnosis to Justify MAC
Question: Our anesthesiologist provided MAC (monitored anesthesia care) during lumbar radiofrequency ligation. He classified the [...] - Reader Question:
20600 Applies to Heel Spur Injection
Question: Which code should I use for a heel spur steroid injection?
Oregon Subscriber Answer: The [...] - Reader Questions:
64483 and 64484 Are for Lumbar Nerve Root Blocks
Question: What code should I use for a lumbar nerve root block?
Florida Subscriber
Answer: You should [...]
