Anesthesia Coding Alert

Question: Our anesthesiologist used a pump oxygenator during a coronary artery bypass graft (CABG). How should I code for this?

Montana Subscriber

Answer: Your anesthesiologist used the pump oxygenator, so you'll report 00562 (Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator). If he had performed the procedure without it, you should report 00566 (Anesthesia for direct coronary artery bypass grafting without pump oxygenator).

What's the difference: Most physicians use the pump oxygenator during CABG cases. However, some are opting to complete the procedure without this device, usually when the procedure is a single or double bypass.

Always check: You should always be able to find an indication of whether your anesthesiologist uses the pump oxygenator in his notes, especially when the procedure is completed off-pump. Make sure that you remind him of the necessity of clear documentation. This is especially important in cases such as this when the off-pump code has five more base units than the on-pump code.