Anesthesia Coding Alert

Question: The physician began a colonoscopy with MAC (monitored anesthesia care), but then decided to perform an open hemicolectomy with a general anesthetic. Should I bill the whole procedure as if general anesthesia were the only type used, or should I report two procedures under different types of anesthesia?

Virginia Subscriber

Answer: You can only bill anesthesia for one procedure, even if multiple procedures are performed during the same session.
 
When multiple procedures are performed, you report anesthesia based on the higher-base procedure. In this case, that means you code for the hemicolectomy with a general anesthetic instead of the colonoscopy with MAC.
 
Report code 00840 (Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified), which is six base units plus time.
 
Even though you're only coding for one procedure, you do report the total amount of time associated with both procedures.