Anesthesia Coding Alert

Question: We bill for an anesthesiologist who performs anesthesia for a pain management doctor. The pain management physician performs 64626 (Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level) and +64627 (... cervical or thoracic, each additional level [list separately in addition to code for primary procedure]). Which anesthesia code should I use?

North Dakota Subscriber

Answer: You need to know what position the patient was in so you can choose the appropriate crosswalk code. In the anesthesia crosswalk, these codes correspond to the patient's position at the time of the injection:

• 01991 -- Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different provider); other than the prone position

• 01992 -- ... prone position.

If the patient was lying on his stomach or in the prone position, you would use 01992. If the position was other than prone, that is, lying on his back or side, use 01991.

Note: If you have a 01992 and another anesthesia procedure with a lesser base unit performed at the same time, you would use the highest base anesthesia code and the total time involved for both procedures.

Don't forget: CPT states that you cannot report 01991 or 01992 with 99143-99150 (Moderate sedation services ...).