Anesthesia Coding Alert

Question: What is the best way to bill for difficult intubations? Should we append a modifier, or is there another CPT code to use?


Texas Subscriber

Answer: When the anesthesiologist performs intubation as part of the anesthesia service, consider it part of the anesthesia code and base units for the procedure, regardless of the complexity of the service. The procedure's anesthesia time also includes the extra time involved with a difficult intubation.

Physicians expect the factors to average out over time: They don't bill extra units for a difficult intubation, but they also don't bill fewer units for easier ones. Some coders do recommend sending a courtesy letter to the patient advising him of the situation so he can be prepared for future surgeries.