Wiki ASA CROSSWALK PAIN MANAGEMENT INJECTIONS

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MLITE2113

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I am struggling with making a decision at our practice regarding the ASA codes for PM injections 64483,62321,62323 etc.... Any injection code that crosswalks to 01992 and 01991.
I understand medical necessity is a huge issue but my question only pertains to the crosswalk codes. If you have any suggestions/info on what the providers need to document in order to make anesthesia medically necessary please feel free to let me know.
My main concern is the 01992 and 01991 crosswalks.. Our State Medicaid system (Michigan) does not have these 2 codes on their fee schedule. I have asked 2 different coders if it is ok to use the 01938 or 01939 instead even if it's not on the crosswalk. They said it was ok but, I'm concerned that 2 years from now when we have a regular audit that they will be able to take the payments back.
We would like to use the 01938 and 01939 across the board and not just for Medicaid and Medicaid plans. Would this be appropriate even for Medicare who still pays the 01991,92.
Thank you in advance for any and all suggestions and documentation on this subject.
 
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Hi there, the descriptors for anesthesia codes 01938 and 01939 are clear: "Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent ..."

Epidurals aren't destructive procedures, so I don't see how billing those anesthesia codes could stand up to an audit.

Also, if you want guidance on medical necessity of anesthesia for epidurals, read the ASA's statement on anesthesia for interventional pain management procedures https://www.asahq.org/standards-and...ing-interventional-pain-procedures-for-adults
 
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Hi Thank you
Sorry I meant 01937 and 01938 these clearly state Anesthesia for percutaneous image-guided INJECTION, drainage or aspiration procedures on the spine or spinal cord.
I understand that 01939 and 01940 are the DESTRUCTION codes.
Can 01937 and 01938 be used for CESI, LESI, TFESI?
 
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MLITE2113 said:
Hi Thank you
Sorry I meant 01937 and 01938 these clearly state Anesthesia for percutaneous image-guided INJECTION, drainage or aspiration procedures on the spine or spinal cord.
I understand that 01939 and 01940 are the DESTRUCTION codes.
Can 01937 and 01938 be used for CESI, LESI, TFESI?
Click to expand...
My apologies, I was using an online tool to look at descriptors. Anyway, yes. You'd use the anesthesia for spine injection codes with the spine injection procedures.
 
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Do you happen to have experience with code 64483 being billed by facility and administering doc (pain management) and CRNA billing 01992 with QZ modifier? Three separate claims. CRNA is only monitoring vitals with no anesthetic given. Max of 10 min. The CRNA does do a pre-op consult.
 
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jkyles said:
Sorry I just saw this message. Are you using the latest edition of the ASA's Crosswalk?
Click to expand...
Do you happen to have experience with code 64483 being billed by facility and administering doc (pain management) and CRNA billing 01992 with QZ modifier? Three separate claims. CRNA is only monitoring vitals with no anesthetic given. Max of 10 min. The CRNA does do a pre-op consult.
 
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jkyles said:
My apologies, I was using an online tool to look at descriptors. Anyway, yes. You'd use the anesthesia for spine injection codes with the spine injection procedures.
Click to expand...
Scarver82 said:
The crosswalk book does not cross 64483 to 01991 or 01992. How are you getting away with billing those?
Click to expand...
Do you happen to have experience with code 64483 being billed by facility and administering doc (pain management) and CRNA billing 01992 with QZ modifier? Three separate claims. CRNA is only monitoring vitals with no anesthetic given. Max of 10 min. The CRNA does do a pre-op consult.
 
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