Anesthesia Coding Alert
Unusual Positions Mean Extra Units--Sometimes
Question: The surgeon placed the patient in the left lateral position for surgery on the right arm. Our anesthesiologist wants to add one unit to the bill because of the patient's position. Is this correct, and how should I report it?
Virginia Subscriber
Answer: When the surgeon places the patient in an unusual position, most coders add enough units to the procedure's base to equal a total of five.
For example: A lower-arm code such as 01820 (Anesthesia for all closed procedures on radius, ulna, wrist or hand bones) is three base units, so you would add two units for the unusual position. A shoulder code such as 01630 (Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified) is five base units, so you don't add extra units because of the patient's position.
Include "lateral position" in Box 19 of the CMS-1500 form to help explain the extra unit charge.
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