Anesthesia Coding Alert

Question: A patient scheduled for an open cholecystectomy was found to have severe gangrene of the gallbladder with intra-abdominal abscess. Open drainage of the intra-abdominal abscess was performed. The surgeon could perform only a partial cholecystectomy because of the gallbladder’s condition. How do we code for the anesthesiologist’s service?

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Answer: The surgical coder will report 47600 (Cholecystectomy) with modifier 52 (Reduced services) since the surgeon did not complete the full procedure. The corresponding anesthesia code is 00790 (Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified). Since anesthesia services are billed by time, the fact that the surgeon didn’t complete the fully anticipated procedure doesn’t change your coding from an anesthesia standpoint. Code 00790 carries 7 base units, so report that with the applicable time units, which are usually less than expected based on the surgeon’s reduced services.