Anesthesia Coding Alert

Question: How should we code fiberoptic intubations? It seems that the coders I've spoken to about this topic can't agree on the correct code.


Montana Subscriber

Answer: The answer depends partly on the circumstances. In most cases, when the anesthesiologist performs intubation it is either part of the anesthesia service or an emergency intubation. If it is part of the anesthesia service, you do not report it separately because it is included in the anesthesia code's base units. If the anesthesiologist performs it as a surgical (flat-fee) procedure, report 31500 (Intubation, endotracheal, emergency procedure).

Code 31575 (Laryngoscopy, flexible fiberoptic; diagnostic) describes fiberoptic intubation, but ENT surgeons who are examining the larynx for disease primarily use this technology. An anesthesiologist might report 31575 in rare circumstances, such as if no surgeon is available and the anesthesiologist must address an immediate problem (airway obstruction from a foreign body or similar situation).