Anesthesia Coding Alert

Question: An anesthesiologist in our practice provided services during an excision of vaginal cuff. We used an unlisted code: 58999. How do I know what the crosswalk code would be?

Colorado Subscriber

Answer: Since anesthesia codes are based on location, you would first need to check the physician's notes from the procedure to see where and how it was performed.

The most likely scenario is that the surgery was done through the vagina, in which case you would use 00942 (Anesthesia for vaginal procedures [including biopsy of labia, vagina, cervix or endometrium]; colpotomy, vaginectomy, colporrhaphy, and open urethral procedures).

You might want to double-check the physician's notes from the procedure to see where and how the procedure was performed. In the unlikely event that the vaginal cuff was reached through an abdominal approach, you would use two units of 00840 (Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified) for intraperitoneal anesthesia.

When reporting an unlisted procedure code, such as 58999 (Unlisted procedure, female genital system [nonobstetrical]), you can still cross over to an anatomically correct anesthesia code. Just be sure the surgical procedure is not investigational, but a covered procedure.