Anesthesia Coding Alert
Payers Might Have Specific Bundling Issues
Question: Sometimes I cannot find my two code pair in the CCI edits. How do I know which code would be considered a column 1 code and which would be considered a column 2 code so that I could put my modifier on the correct code? Kansas Subscriber Answer: If the codes are not listed, the codes are not bundled per the Correct Coding Initiative (CCI). You would not need a modifier to override the edit. If the codes are not listed in CCI, simply report them as you normally would without a bundle-breaking modifier. A private payer could have proprietary bundling edits that may or may not be published, aka black box edits. You would need to check with a payer rep for a recommendation. You can also find Medicare's other allowed modifiers in the Medicare Physician Fee Schedule. Columns Y-AC indicate if modifier 51, 50 etc. apply. This info is also in Codify's fee schedule information (Fee Schedule 2013).
Anesthesia Coding Alert
- GI Procedures:
Remember One Simple Code to Help Justify Anesthesia for Colonoscopy
Including supporting documentation can also help your cause.ICD-9 Codes 2010 introduced a new V [...] - CCI 17.1:
Report Codes 36620, 93503 Over Paravertebral Facet Joint Injections
Latest CCI edits also classify plantar injections as comprehensive procedures.When your anesthesiologist places a Swan-Ganz [...] - Pain Management:
Follow 2 Simple Tips for Trigeminal Nerve Block Success
Heads up: Watch for other names that could mean trigeminal.If your physician administers trigeminal nerve [...] - ICD-10:
Expand Your Cubital Tunnel Syndrome Options With ICD-10
Tip: Clarify MD's notation of CTS before coding.You currently have a single diagnosis choice when [...] - You Be the Coder:
Remember Diagnosis to Support 62311 Post-Op
Question:Our state's Medicaid carrier denies our claims when we submit CPT 62311 with modifier [...] - Reader Questions:
Code With +99135 for Controlled Hypotension
Question:One of the anesthesiologists we code for wants to bill for controlled hypotension on shoulder [...] - Reader Questions:
Watch Location to Choose Between 01210 and 01230
Question:When is it appropriate to use anesthesia code CPT 01230 versus 01210?Nebraska Subscriber Answer: [...] - Reader Questions:
Report Units, Not Separate Lines, for MC Injection Claims
Question:The physician administered transforaminal epidural steroid injections to the right L3, L4, and L5. How [...] - Reader Questions:
OR Report Will Point to 00472 or 00540 for Pectoralis Flap Closure
Question:The anesthesia record documents a pectoralis flap reconstruction that included debridement of sternal wound infection, [...] - Reader Questions:
Modifier Q6 for Locum Tenens Is Only for MD
Question:What is the rule for billing CRNA services as locum tenens?Florida Subscriber Answer: Locum tenens [...] - Reader Questions:
Look to 20550 for Iliotibial Injection
Question:Our physician administered an iliotibial injection with steroids. How should we code the procedure?Wisconsin SubscriberAnswer: [...] - Reader Questions:
Phone Chat Doesn't Always Mean 99441-99443
Question:A new patient came to our office, and the physician did a complete workup, resulting [...] - Reader Questions:
Steer Clear of Modifier PT for Anesthesia
Question:Can you tell me about the new modifier PT? Can we use it when providing [...] - Reader Questions:
Payers Might Have Specific Bundling Issues
Question:Sometimes I cannot find my two code pair in the CCI edits. How do I [...] - Reader Questions:
Procedure Includes Bupivicaine Anesthetic
Question:How should we code for bilateral greater occipital nerve blocks with 1.5 cc of bupivacaine [...]
