Anesthesia Coding Alert

Question: Where would the incision be made for a procedure to be considered "upper" when I'm choosing the anesthesia code? I'm specifically interested in how to categorize a colectomy.

Minnesota Subscriber

Answer: The dividing line between upper and lower abdominal procedures is the belly button (or umbilicus). The challenge comes because many times the provider documents "midline incision," which isn't as descriptive. Remember that from a coding perspective it doesn't matter where the incision is made -- you should focus on where the work is performed. In your example of a colectomy, the colon is considered upper abdomen (unless work is exclusively on sigmoid or rectum). You would code the anesthesia with 00790 (Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified), which has a base value of 7.