Anesthesia Coding Alert

Studying up now could reduce denials in January for pain management, too. CPT Codes 2009 has plenty of updates for anesthesia coders to grasp, but these changes are designed to help make your job easier. "Two new anesthesia codes could help streamline your reporting processes," says Kelly Dennis, MBA, CPC, ACS-AP, of Perfect Office Solutions Inc. in Leesburg, Fla.: 1. 00211 -- Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma In 2008, the crosswalk options for these intracranial procedures were either 00210 (Anesthesia for intracranial procedures; not otherwise specified) with a base of 11, or 00218 (Anesthesia for intracranial procedures; procedures in sitting position) with a base of 13. "The new code is a one unit reduction in 2009, unless the patient is in sitting position," says Dennis. 2. 00567 -- Anesthesia for direct coronary artery bypass grafting; with pump oxygenator Don't miss: CPT 2009 added a semicolon to the descriptor to allow 00566 (Anesthesia for direct coronary artery bypass grafting; [CABG] without pump oxygenator) to become a parent code to code 00567, Dennis points out. The addition of the new CABG code with pump oxygenator results in a two unit reduction in 2009, unless the procedure involves both coronary and valve work. New Codes Arrive for Plantar Nerves and Back Pain CPT adds a couple of plantar nerve 64xxx codes and several performance measure codes for the new back pain clinical condition for 2009. 1. 64455 -- Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (e.g., Morton's neuroma) This new code is important because of its specificity -- it's clearer than using 64450 (Injection, anesthetic agent; other peripheral nerve or branch). Plus, some Medicare carriers, such as Noridian,-had issues with providers reporting 64450 for an injection of Morton's neuroma and wanted you to use 64999 (Unlisted procedure, nervous system), says Marvel J. Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, of MJH Consulting in Denver. The AMA directs providers to report 64455 one time only, regardless of the number of injections performed during a session. 2. 64632 -- Destruction by neurolytic agent; plantar common digital nerve Like 64455, this code adds more specificity than using 64640 (Destruction by neurolytic agent; other peripheral nerve or branch), Hammer points out. Pain Management Codes Get a Boost Various Category II codes have been created for the back pain performance measure: • 0525F-0526F -- Visit for episode • 1130F-1137F -- Back pain assessment • 2040F -- Physical examination on the date of the initial visit for low back pain performed, in accordance with specifications • 2044F -- Documentation of mental health assessment prior to intervention (back surgery or epidural steroid injection) or for back pain episode lasting longer than six weeks • 3330F -- Imaging study ordered • 3331F -- Imaging [...]