Wiki iud under anesthesia

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We are trying to prior auth a procedure with our local medical assistance program for IUD insertion under anesthesia. The regular insertion code includes local anesthesia, but we will be doing this at the hospital under anesthesia. Will we code this any differently than regular insertion?
Julie
 
What is the medical necessity for general anesthesia versus local anesthesia? You will have to have that as your primary dx with a V25.1 as a second or third if you have more dx to code.

I would request prior auth for 58300, 00940 with a 23 modifier for unusual anesthesia.

I hope this helps you.
 
Thanks for your much needed advice!!
The reason is because the physician feels it is unsafe to do it in the office as he has a feeling she is going to freak out and try to jump off the exam table and possibly be hurt during the insertion. She just doesn't seem to be "all there". Just during the consultation she started screaming and crying and freaking out just talking about the procedure...

So I don't even know what dx to use for that???
 
Does she have a history of mental disturbances or anxiety? You could use 300.00 for atypical anxiety disorder. Make sure you have the documentation of what she did when she came in for the consult when you send in the prior auth. Even if its the consult notes, it will back up your claim for needing general anesthesia.
 
She does - thank you so much for your help. We're going to send this off for prior auth now and hope for the best!
Julie
 
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