Anesthesia Coding Alert

Question: I'm trying to code correctly for a mediastinoscopy, with or without biopsy. A CRNA is performing the procedure under the medical direction of one anesthesiologist. What is the most accurate way for me to code this?

Idaho Subscriber

Answer: If you're using one-lung ventilation, you should report 00529 (Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thorascopy utilizing one-lung ventilation). If you're not using one-lung ventilation, report 00528 (... mediastinoscopy and diagnostic thorascopy not utilizing one-lung ventilation).

More info: If you're coding for the CRNA, you would use modifier QX (CRNA service: with medical direction by a physician). For the anesthesiologist, use modifier QY (Medical direction of one certified registered nurse anesthetist [CRNA] by an anesthesiologist).