Anesthesia Coding Alert

Question: We have a debate in our office regarding how to bill for anesthesia during gastroenterology endoscopy services. Some of our staff say to report a standard anesthesia code, others say to report something from the moderate sedation codes. Which is correct? The particular case I’m coding mentioned that the sedation plan was MAC; the anesthesiologist used 200 mg of Propofol and administered anesthesia for 17 minutes. What is the correct coding strategy?

Wisconsin Subscriber

Answer: Remember, moderate sedation codes rarely apply to anesthesiologists. You should report the service with the most appropriate anesthesia code (00100 - 01999) since the medical report indicates the sedation plan as MAC (monitored anesthesia care).

Possible options, depending on the actual circumstances, include:

• 00731 – Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified
• 00732 – … endoscopic retrograde cholangiopancreatography (ERCP)
• 00811 – Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified
• 00812 – … screening colonoscopy
• 00813 – Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum.

Choose the appropriate code based on the procedure performed.