Anesthesia Coding Alert

Question: Some surgeons have started requesting that our providers use epidural anesthesia in lieu of general anesthesia for qualified hip and knee replacement candidates. I have confirmed with the anesthesia providers this is not a nerve block for pain in addition the general, as that was my first thought. I know I can’t use the 01967 epidural code as it is specific to obstetrics. What is the appropriate code to use for this anesthesia?

North Carolina Subscriber

Answer: In the event the epidural is the primary anesthetic, the coding process doesn’t change.

You are correct in saying that 01967 (Neuraxial labor analgesia/anesthesia for planned vaginal delivery…) would not be the appropriate code in the scenario you’re describing since it is designed for labor and delivery.

In cases of hip and/or knee replacement, determine the correct surgical code for the procedure and crosswalk it to the appropriate anesthesia code:

• Total hip replacement: Code 27130 (Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft) crosses to anesthesia code 01214 (Anesthesia for open procedures involving hip joint; total hip arthroplasty).
• Total knee replacement: Code 27447 (Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)) crosses to anesthesia code 01402 (Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty).