Anesthesia Coding Alert

Are you ready to code anesthesia for open pelvic ring repair?It may not crop up in every anesthesiologist's day, but anesthesia for pelvic procedures has undergone coding changes that every anesthesia coder should know how to apply. Here's the latest on these unique procedures.Not All Pelvic Bone Injuries Are EqualThere are a number of CPT anesthesia codes dealing with pelvic injury procedures, including these:• 01120 -- Anesthesia for procedures on bony pelvis• 01170 -- Anesthesia for open procedures involving symphysis pubis or sacroiliac joint• 01173 -- Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum.Patients sustaining severe pelvic injuries can suffer impact so forceful that the pelvic circle is disrupted. Anesthesia for patients with this problem is significantly different from that of most patients receiving anesthesia for other hip procedures. Here's what you need to know to determine which code to apply to your claim.Start With Glimpse at 01120Code "01120 encompasses a significant range of procedures on the bony pelvis in general," says Cindy Lane, CPC, CHCC, of Advanced Coding Solutions, LLC, in White House, Tenn."It covers both open and closed procedures and includes bone aspirations, debridements, fracture treatments, and others," Lane says.Discover Which Codes 01173 Applies ToGet hip: Often, patients with a disrupted pelvic circle are multiple-trauma victims. They will often present with multiple, significant injuries plus acute comorbidities directly impacting your anesthesiologist's decision making. These patients require specific fluid management measures, blood and blood product replacement, and high-skilled airway management. The difficulty of providing correct anesthesia care for such patients is greatly increased. As a result of the additional work needed to administer anesthesia to these patients, CPT added 01173 to describe the procedure."Code 01173 is the most specific and is used strictly for three procedures that involve the open treatment of an acetabulum fracture," Lane says. The only three surgical codes that cross to 01173 are the following, she says:• 27226 -- Open treatment of posterior or anterior acetabular wall fracture, with internal fixation• 27227 -- Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation• 27228 -- Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation."Just as noteworthy is the fact that those three surgical codes only cross to 01173," Lane says. Unlike many other anesthesia codes, she adds, you do not have to choose between multiple anesthesia codes.Here's How to Choose Among Your Options01173: Because codes for pelvic procedures expanded in 2003 and provided you more specific options, you should use 01173 instead [...]