Anesthesia Coding Alert

Question: The CRNA provided anesthesia for surgery noted as “Septoplasty, ASA 2.” For billing CRNA services, would CPT^® 00160 or 00162 be more appropriate? I know we’ll also need to append some modifiers.

Pennsylvania Subscriber

Answer: The correct anesthesia crosswalk code for a procedure is not affected by whether the service is provided by an anesthesiologist or another provider. The surgical septoplasty code 30520 (Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft) crosswalks to anesthesia code 00160 (Anesthesia for procedures on nose and accessory sinuses; not otherwise specified). Code 00160 carries five anesthesia base units.

Anesthesia code 00162 (Anesthesia for procedures on nose and accessory sinuses; radical surgery) is not appropriate since a septoplasty is not usually considered to be “radical surgery.”

You also mention the need for modifiers. Unless other considerations apply, you will only need to report a modifier representing the anesthesia provider. For the CRNA, that could be either modifier QX (CRNA service: with medical direction by a physician) or QZ (CRNA service: without medical direction by a physician).

Caveat: Modifiers may be related to the specific insurance. For example, Texas Medicaid would require both modifiers (QX U2). Check with the state payers for guidance.