Wiki Et/emerg anesthesia

[nabernhardt]

We are a CAH hospital and are trying to determine the best way to bill out for when a crna comes to the ER and does an emergency intubation? Is it correct to use base units. The cpt code is 31500. But how do we properly capture this for the crna.

Second when our crnas are called in for an emergency procedure and has to provide anesthesia. Is it best to use the 99140 or wrap it into an OR level.

Any suggestions or resources for the emergency intubation or emergency anesthesia please
Thanks

 

[nabernhardt]

I posted this awhile back but did not get any responses back. We are still trying to determine the best way to charge for an emergency intubation when done by one of our CRNAs. Does anyone have any suggestions please?

 

[Michele Hannon]

A CRNA can bill for 31500 (6 base units) according to 2012 RVU guide page 42.
The CRNA needs to document a note on the patient's chart about the intubation.

99140-will only be recognized if there is a documented threat to life or limb.
Just because a patient comes to the Operating Room from the Emergency Room does not constitute use of 99140.

Examples of threat to life or limb:
open fracture
non-reassuring fetal monitor
acute abdomen-perforated viscus

Examples of urgent cases not subject to 99140:
fractured hip
failure to progress-OB

 

[nabernhardt]

thank you so much.

 

[nabernhardt]

one more question if you can answer this would we use the QZ modifier on the 31500

 

[nabernhardt]

could anyone help me with what REV code to use for the 31500 in the E.D. please?
thanks

 

[TammyW]

If the CRNA performed the intubation, then you bill with the code 31500, no QZ modifier, no time. Because you are billing a surgical code, not an anesthesia code.
If the CRNA just sedates the patient so another provider could perform the intubation, then you use an anesthesia code. Keeping in mind, intubation is an integral part of general anesthesia.