Anesthesia Coding Alert

Question: How do I determine the correct diagnosis codes for billing anesthesia? Should I report only the diagnosis associated with the highest-base CPT code regardless of how many procedures the surgeon performed? Or should I rely on the provider's documentation of surgical indications for the procedure? 


Iowa Subscriber
 

Answer: Some coders like to report multiple diagnoses because it can help give a clearer picture of the situation. But because additional diagnoses do not affect your payment, other coders only report the diagnosis appropriate to the procedure.

Some carriers such as Medicare only accept one diagnosis when you file a claim electronically. On the other hand, some Medicaids and private carriers want multiple diagnoses if you report a status of P3 (A patient with severe systemic disease) or higher.

Carriers in some areas (such as California), however, state that the additional diagnosis cannot be related to the reason for surgery. Always verify the carrier's guidelines in these situations.