Tag Archives: anesthesia
CCI Edits: Say Good-Bye to Reporting Anesthesia With Needle EMGs
Posted on 13. Feb, 2013 by rpandit.
Plus: Pay close attention to modifier indicators in CCI 19.0.
The first round of Correct Coding Initiative (CCI) edits for each year is usually the most extensive, and CCI 19.0 effective January 1, 2013, is no exception. We’re here to highlight a few things from the more than 2,050 edits that involve anesthesia codes so you can continue submitting accurate claims for your provider’s services.
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High BMI: To Use Or Not to Use Modifier 22
Posted on 12. Apr, 2011 by dchandhok.
The new fifth-digit diagnosis codes for body mass index (BMI) can help you better document a patient’s condition, especially when the patient’s BMI might contribute to more complex risk factors for the anesthesiologist to handle. Having documentation of a high BMI doesn’t automatically lead to more pay, however. Watch two areas before assuming you can automatically append modifier 22 (Increased procedural services) because of BMI and potentially score a 20-30 percent higher pay for the procedure.
Not All Morbid Obesity Means Modifier 22
A patient is considered to be morbidly obese when his or her BMI is 40 or more. New BMI codes for 2011 include:
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Unlock Pay With Anesthesia V Code Advice
Posted on 07. May, 2010 by Editor.
Don’t be caught asleep: Patient history is one element of proper Dx coding.
Many coders hesitate to report V codes, or simply use them incorrectly, but sometimes this section of ICD-9 most accurately describes the reason for the patient’s condition. In fact, V codes are often essential to reporting an anesthesia patient’s medical history.
If you’re not clear on the importance of V codes, check out these expert-approved answers to some often-asked questions:
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Mind Your P Modifiers or Leave Money on the Table
Posted on 28. Apr, 2010 by Editor.
Have your documentation ready for reporting level P4 and higher.
Physical status modifiers, also referred to as P modifiers, PS modifiers, ASAs or ASA P codes, are an important element of your anesthesia coding. If you don’t use them correctly, you could dash your reimbursement opportunities, or risk a payer audit.
Skip P Modifiers With Medicare, But Check Private Payers
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Anesthesia Coding Education: Combined Spinal Epidural
Posted on 17. Jan, 2010 by .
Question: Our anesthesiologists sometimes mark our C-section tickets as “combined spinal epidural,” but our billing system will only allow us to choose epidural or spinal. Where can I find information about spinal epidurals and how to correctly code them?
Answer: From a coding perspective, whether your physician used spinal or epidural anesthesia doesn’t matter as long as you report the correct obstetrics code. Base your anesthesia code on the case specifics:
• 01961 (Anesthesia for cesarean deliver only) for a straight c-section instead of converting from labor to a csection
• 01967 (Neuraxial labor analgesia/anesthesia for planned vaginal deliver [this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor]) for a standard labor and vaginal delivery
• +01968 (Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia [List separately in addition to code for primary procedure performed]) for a planned vaginal delivery that changes to a cesarean section.
© Anethesia & Pain Management Coding Alert. Download your 2 FREE sample issues here.
2010 Anesthesia Coding Reference Audio Collection.
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Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010
Posted on 29. Oct, 2009 by .
Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready for a facet joint codes shift that preps for ICD-10.
The 2010 version of CPT attempts to organize the facet joint injection codes by deleting 64470-64476 and debuting 64490- 64495 in their place, as follows:
• 64490 — Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level
• 64491 — … second level
• 64492 — … third and any additional level(s)
• 64493 — Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level
• 64494 — … second level
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Anesthesia Coding Education: Sciatic Nerve Block & Same-Day General Anesthesia
Posted on 22. Oct, 2009 by .
Question: My anesthesiologist performed a sciatic nerve block for a patient with postoperative pain on the same day he provided general anesthesia for that patient’s knee surgery. How should I code this?
Answer: Use modifier 59 (Distinct procedural service) when you need to show that your physician performed two distinct services on the same day. When your physician places a sciatic nerve block for postoperative pain management (for example, 64445, Injection, anesthetic agent; sciatic nerve, single), and on the same day provided general anesthesia for knee surgery (01400, Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified), your final codes are 64445-59 for the block, along with 01400 for the anesthesia.
AUDIO: Take the billing ache out of postoperative pain. With Joanne Mehmert, CPC, CCS-P.
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Anesthesia Coding: Stop Hypothermia Errors Cold
Posted on 06. Oct, 2009 by .
3 criteria signal when +99116 is OK.
Before you can capture qualifying circumstances pay for hypothermia, pay attention to certain documentation details and requirements. Checking the details in your provider’s notes and paying close attention to the applicable anesthesia code can help you ward off any fears of incorrect reporting.
To find the code for hypothermia, you’ll need to flip to the back of your CPT book to “Qualifying Circumstances for Anesthesia.” The code you’ll focus on is +99116 (Anesthesia complicated by utilization of total body hypothermia [List separately in addition to code for primary anesthesia procedure]).
1. Ensure Hypothermia Is Induced
Dissecting the hypothermia code descriptor tells you two important things about correctly reporting +99116:
• The term “utilization” lets you know that the patient’s hypothermic state was induced (that is, on purpose), not incidental.
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64450 or 64421: Which Code to Tap for TAP Block?
Posted on 10. Jul, 2009 by .
Question: What exactly is a “tap block,” and what code do I use?
Answer: A transverse abdominus plane (TAP) block is typically used for post-operative pain management following major abdominal surgery. Your provider may also use it as an adjunct to his anesthesia for abdominal laparoscopic procedures. If performed for postoperative pain management, report 64450 (Injection, anesthetic agent; other peripheral nerve or branch). Another option is 64421 (Injection, anesthetic agent; intercostal nerves,multiple, regional block).
Watch out: If the block is used as part of the anesthesia — not for post-operative pain management — do not report it separately from the anesthesia services code.A TAP block is particularly useful for patients where an epidural is contraindicated or refused. The TAP can be performed unilaterally (for example, for an appendectomy), or bilaterally when the incision crosses the midline (such as a Pfannenstiel incision). A single injection can be utilized, or a catheter may be inserted for several days of analgesic benefit.
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CCI 15.2 Retracts Neurostimulator Edits from 15.1
Posted on 01. Jul, 2009 by .
Look for new edits that affect eye exam codes, anesthesia, and vent management.
The Correct Coding Initiative (CCI) may have startled coders with what looked like a twisted April Fool’s prank: the April 1 edit bundling applied neurostimulator code 64550 into hundreds of other procedures. But new version 15.2 corrects that error, deleting these bundles retroactive to April 1, 2009.
The new version of CCI, which takes effect on July 1, does bundle 64550 (Application of surface [transcutaneous] neurostimulator) into several anesthesia codes (such as 01920 and 01922), “but this is nothing considering that code was bundled into practically every other code in CPT prior to the new CCI deletions,” says Atlanta-based coding consultant Jay Neal.
Use the appeals process like a pro. An audio training event with Barbara Cobuzzi.
Anesthesia affected: Of the 3,565 new edit pairs, a full 65 percent of the column 1 codes are in the 00100-01999 range, according to analysis by Frank Cohen, senior analyst with MIT Solutions, Inc. This means that more services than ever are bundled into anesthesia codes.
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