Anesthesia Coding Alert

Question: How should I report flat-fee procedures (such as Swan-Ganz catheters, TEE probes or arterial lines) with anesthesia? Do I include them on the same claim as time-based anesthesia services?


Montana Subscriber

Answer: The anesthesiologist or surgeon can perform these types of invasive services, so verify who performed the procedure before you bill for it. The anesthesiologist should document these types of invasive procedures on the anesthesia record. Some groups include an -Indication- box on the record with a list of possible services so the provider can simply check what he did--and make it easier for you to code accordingly.

You can submit flat-fee and time-based services on the same claim. Report the flat-fee procedure (such as Swan-Ganz placement) in addition to the procedure for which the physician administered anesthesia.

Example: Your physician administers anesthesia during a heart procedure using a pump oxygenator. Report 00562 (Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator) for the main procedure. Report other services on additional lines and with modifier 59 (Distinct procedural service), such as 36620-59 (Arterial catheterization or cannulation for sampling, monitoring or transfusion [separate procedure]; percutaneous) for arterial line insertion and 93503-59 (Insertion and placement of flow directed catheter [e.g., Swan-Ganz] for monitoring purposes) for Swan-Ganz insertion.

You Be the Coder and Reader Questions were reviewed by Emma LeGrand, CCS, CPC, office manager for New Jersey Anesthesia Associates in Florham Park..