Anesthesia Coding Alert

Question: Can anesthesia codes be billed with modifier 50? For example, can 00120 be billed with a 50 for a bilateral procedure?

Kansas Subscriber

Answer: Anesthesia reimbursement is based on a formula incorporating the number of base units assigned to the applicable anesthesia code, the time spent on anesthesia administration, and other factors. If the provider completes multiple procedures during the same encounter, you choose the code with highest base units and report it with the total amount of time for all procedures. In most instances, modifier 50 (Bilateral procedure) applies to the surgeon or other professional performing the procedure, not the anesthesiologist. 

Exception: The only time an anesthesiologist would use a modifier 50 is when he or she performs the actual procedure instead of only administering anesthesia. For example, you would report bilateral sacroiliac joint injections as 27096 (Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance [fluoroscopy or CT] including arthrography when performed) with modifier 50 appended.