Anesthesia Coding Alert

Question: A 16-week-old had multiple medical conditions including rhizomelic chondrodysplasia and central and obstructive sleep apnea. The infant was in the neonatal ICU and declining on nasal BiPAP. The ENT team was asked to intubate the patient in the OR with the anesthesia team, as the infant was reported to have a very difficult airway from prior operations. How do I code an intubation for a four-month-old that we provided general anesthesia for?

Delaware Subscriber

Answer: The procedure you describe doesn't have a designated ASA crosswalk code, which means you need to start with the most appropriate cross for the intubation. That would be CPT^® 31500 (Intubation, endotracheal, emergency procedure). Two potential anesthesia choices based on 31500 are 00320 (Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older) for patients age 1 year and older and 00326 (Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age) for patients younger than 1 year. You would submit 00326 in this situation. Be sure to include thorough documentation supporting the medical necessity of anesthesia.