Anesthesia Coding Alert

Question: We have been told that our CRNA's codes must identically match those billed by the anesthesiologist. The MDs give us a diagnosis and/or ICD-9 code. Their codes are incorrect about half the time. We have access to the hospital's codes so we can assign the correct code but have no way of knowing what their billing service is using. We use the MD's stop/start time and CPT/ASA, so those are not a problem. Can you verify whether it is just the time and CPT codes that need to match, or whether the ICD-9 coding needs to match as well?

Texas Subscriber

Answer: The only difference between the codes for the anesthesiologist and the CRNA are the modifiers. The only possible exception is if the MD places any lines or performs any services in addition to administering anesthesia. Since the CRNA is working under the supervision of the MD, the CPT/ASA codes and ICD-9 codes should be the same.

Tip: Bill the correct ICD-9 code, but always be prepared to provide supporting documentation. Don't rely on the hospital codes. Look for an operative report that clearly states the diagnosis. Use the diagnosis codes for the diagnosis listed on the anesthesia record.

-- Answers to You Be the Coder and Reader Questions were provided by Scott Groudine, MD, an Albany, N.Y., anesthesiologist; Marvel J. Hammer, RN, CPC, CCS-P, ACS-PM, CHCO, owner of MJH Consulting in Denver; and Kelly Dennis, MBA, CPC, ACS-AP, with Perfect Office Solutions of Leesburg, Fla.