Anesthesia Coding Alert

Update helps clear up confusion about use.

Included in the brand new codes added to CPT for the coming year, there are a number of changes and revisions to codes impacting both anesthesia and pain management coders. The E/M section of CPT in particular undergoes multiple revisions for 2009.

• 99354 -- Prolonged physician service in the office or other outpatient setting requiring direct (face-to- face) patient contact beyond the usual service; first hour (List separately in addition to code for office or other outpatient Evaluation and Management service)

CPT deletes the example in 99354's code description. This is "not a huge change, it's probably more for clarification and perhaps to eliminate any payer confusion over usage," says Marvel J. Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, of MJH Consulting in Denver.

• 99356 -- Prolonged physician service in the inpatient setting, requiring unit/floor time beyond the usual service; first hour (List separately in addition to code for inpatient Evaluation and Management service)

"CPT added 'unit/floor time' and deleted verbiage regarding direct -- face-to-face -- patient contact and also deleted an example in the code description," says Hammer. "This is more of a correction, as historically, using time as the basis  for a level of E/M service in the inpatient setting was not a 'face-to-face' requirement but rather 'unit/floor' time."

 It appears, Hammer adds, that the AMA is revising the prolonged service code to match the time requirement for the inpatient E/M code.