Anesthesia Coding Alert

Question: One of our providers excised a malignant lesion on the patient’s forearm under general anesthesia. The problem is that we cannot find a code to bill the MAC anesthesia under. Do you have any advice on this?

South Carolina Subscriber

Answer: The correct anesthesia code for this excision is 00400 (Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified).

Depending on the insurance, you may need to append a modifier to 00400 if the provider used monitored anesthesia care (MAC) for anesthesia. Choose between modifier QS (Monitored anesthesia care service) and modifier G8 (Monitored anesthesia care (MAC) for deep complex, complicated, or markedly invasive surgical procedure), depending on the complexity of the procedure and the specific insurer policy. For example, some Medicare Administrative Contractors indicate a G8 modifier will override the QS modifier. Since they both apply to MAC, you should report only one.