Anesthesia Coding Alert

Question: Would you please help me clarify what anesthesia code should be used for a CABG procedure that started off-pump but then was converted to on-pump? I’m leaning toward 00567 but get confused between that and 00566.

New Hampshire Subscriber

Answer: For coronary artery bypass grafting (CABG) anesthesia, the higher base value service occurs when the surgery is performed on a beating heart, which is much more difficult than when the patient is placed on a bypass system during the procedure. You report 00566 (Anesthesia for direct coronary artery bypass grafting; without pump oxygenator) with a base value of 25 for CABG without the pump oxygenator because the procedure is more difficult without the bypass. When the anesthesiologist uses bypass, you report 00567 (Anesthesia for direct coronary artery bypass grafting; with pump oxygenator) with a base value of 18.

As some anesthesiologists will say, at some point the pump will go from “off” to “on.” Always verify that you understand what the provider is trying to say in the documentation before you assign codes and finalize the claim.