Anesthesia Coding Alert

Question: Our physician provided anesthesia during a CT-guided liver biopsy. The procedure code crosses to a surgical code, which I know is incorrect for reporting anesthesia. How do I handle this?

Arizona Subscriber

Answer: Interventional radiologists often perform a CT-guided liver biopsy. Two codes apply to the procedure itself: 47000 (Biopsy of liver, needle; percutaneous) for the biopsy and 76360 (Computed tomography guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], radiological supervision and interpretation) for the guidance.
 
The Crosswalk states that 76360 is a radiologic service related to another diagnostic or therapeutic service. That means you base your anesthesia code on the biopsy code instead of the guidance. Code 47000 crosses to 00702 (Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy), which you bill as 4 base units plus time. Some coders, however, prefer to report 01922 (Anesthesia for non-invasive imaging or radiation therapy) for CT-guided biopsy of any location. It is a 7-unit code that your carrier might accept, so check your local guidelines.