Anesthesia Coding Alert

Question: How should I bill when a procedure such as an anesthesia catheter insertion is performed on conjoined twins? Alabama Subscriber Answer: If only one procedure was performed on two patients, as is most likely the case with conjoined twins, you should bill both with the same anesthesia code, such as 00192 (Anesthesia for procedures on facial bones or skull; radical surgery [including prognathism]) if the babies are joined at the head and being separated. Conjoined twins have blood vessels that cross from Baby A to Baby B. Therefore, you have two patients, although most hospitals will have one medical record until they are separated. Bill both with the same anesthesia code, but report the reason for the catheter for Baby B and report "conjoined twins" (678.1x, Fetal conjoined twins,) for Baby A. Prepare for appeal: You may have to lodge an appeal with the insurance company, but you can [...]