Anesthesia Coding Alert

Answer: Code 00563 (Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest) is correct. The physician did a thoracic aneurysm repair (great vessel of the chest) on pump (bypass time 110 minutes) with hypothermic arrest (24 minutes). This code describes the anesthesia services perfectly.

The appropriate surgical code for this procedure is 33875 (Descending thoracic aorta graft, with or without bypass) if the aneurysm is totally in the chest. If it extends into the abdomen slightly, then use 33877 (Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass).

Remember: The ASA crosswalk is a tool created by the ASA, not the government or insurers to assist you, the coder. The crosswalk helps you find the most appropriate code to describe the anesthesia work most of the time. It is not definitive -- that is why there are often multiple choices, and in unusual circumstances and anesthetic situations this reference can omit the most appropriate anesthesia code in the crosswalk.-In this scenario, whether the aneurysm was entirely thoracic or thoraco-abdominal, 00563 is the appropriate choice because extension into the abdomen is not part of either anesthesia code.