Anesthesia Coding Alert

Answer: Code 22899 (Unlisted procedure, spine) should be acceptable for reports, although most coders aim for more specific codes than the "unlisteds." The correct ASA code depends on the spinal endoscope's location; possibilities include 00600 (Anesthesia for procedures on cervical spine and cord; not otherwise specified), 00620 (Anesthesia for procedures on thoracic spine and cord; not otherwise specified) or 00630 (Anesthesia for procedures in lumbar region; not otherwise specified).

You should also append modifier -QS (Monitored anesthesia care service) for Medicare claims, and either modifier -QX (CRNA service; with medical direction by a physician) or -QZ (CRNA service: without medical direction by a physician), depending on the medical direction situation. Coders in some states should also append modifier -G8 (Monitored anesthesia care [MAC] for deep complex, complicated, or markedly invasive surgical procedure) if local regulations require it.