Reader Question: Use 01968 for Complete C-Section, Not Partial Help   (December 2011)

Question: When an anesthesiologist starts a labor epidural for a vaginal delivery and then a different anesthesiologist is present for a c-section, should we report 01968 or use 01961 because of the different physician?Louisiana Subscriber Answer: Report the first anesthesiologist’s service with 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 the second anesthesiologist, report +01968 [...]

Reader Question: Opt for 01961 for C-Section, Nothing for Injection   (December 2011)

Question: Our anesthesiologist administered spinal anesthesia for a cesarean section and administered an intrathecal morphine injection. How should we code each part of the case? Utah SubscriberAnswer: Report 01961 (Anesthesia for cesarean delivery only) for the delivery. You cannot bill separately for the intrathecal injection because your physician administered it with the c-section anesthesia. You can, however, include the time your physician spent with the injection in the total procedure time. How it could change: [...]

Reader Question: ‘SMP’ Note Means ‘RSD’   (December 2011)

Question: Which diagnosis applies to sympathetically maintained pain? Is it the same as reflex sympathetic dystrophy?North Dakota Subscriber Answer: Yes, sympathetically maintained pain (SMP) and reflex sympathetic dystrophy (RSD) are the same condition. But there’s a third term you need to know: complex regional pain syndrome (CRPS). In 1995, the medical community changed the name RSD to CRPS to better reflect the nature of the condition and to establish a universal term for research purposes. [...]

Reader Question: 00400 Usually Applies to Groshong Removal   (December 2011)

Question: What is the correct code for removal of a Groshong catheter? New Jersey SubscriberAnswer: To answer that question, you must know whether the catheter was tunneled or non-tunneled. For the most part, Groshong catheters are tunneled, so assuming that, the correct code representing the procedure is 36589 (Removal of tunneled central venous catheter, without subcutaneous port or pump); the anesthesia code is 00400 (Anesthesia for procedures on the integumentary system on the extremities, anterior [...]

Reader Question: Calculate Amount for Correct Kenalog Injection Choice   (December 2011)

Question: How should I report an intra-epididymal injection of Kenalog?South Carolina Subscriber Answer: Report 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) for the injection. Then, choose between J3300 (Injection, triamcinolone acetonide, preservative free, 1 mg) or J3301 (…not otherwise specified, 10 mg) for the Kenalog itself, based on your physician’s documentation.

Reader Question: Marcaine Before Injection? Don’t Count on Payment   (December 2011)

Question: We’ve had increasing problems billing and being paid for the medications we use for trigger point and nerve block injections. We bill J1094 for Dexamethasone 4 mg, S0020 for Marcaine 0.5%, and J2010 for Lidocaine 2%. We never get paid for the Marcaine and rarely get paid for the Dexamethsone. Are there other drugs we should be using? Or are we using the correct drugs with the wrong codes? North Carolina Subscriber Answer: Physicians [...]

Reader Question: List As Many PQRS Codes As Needed   (December 2011)

Question: Can we report more than one PQRS code measure on the same claim?Answer: Yes. You aren’t limited to reporting just one Physician Quality Reporting System (PQRS) code per visit. “EPs [eligible professionals] may submit multiple codes for more than one measure on a single claim,” CMS says in its PQRS Implementation Guide. “Multiple CPT Category II and/or G-codes for multiple measures that are applicable to a patient visit can be reported on the same [...]

Reader Question: Avoid Separate Coding for Bier Block   (December 2011)

Question: Our physician used a Bier block during treatment of CRPS-upper extremity. Is there a Medicaid approved code for Bier block that we can submit? Indiana Subscriber Answer: Physicians usually administer Bier blocks along with monitored anesthesia care (MAC), but can use the block in conjunction with other anesthesia routes. In any case, the fee for MAC or any other anesthesia includes Bier block, so you shouldn’t report the block separately. Just submit the appropriate [...]

Reader Question: Make Up for Lost Time With 5010 Implementation   (December 2011)

Question: We’re behind schedule with our HIPAA 5010 implementation and are not sure that we’ll be ready for it on January 1. What can we do to get on track? Minnesota Subscriber Answer: Even though you might be behind schedule in the testing phases, start now before it does become too late. Focus on testing things with your clearing house until all error messages are gone. Other tips from experts include: Check whether your clearinghouse [...]

CPT^® 2012: 62310, 62318 Revisions Help Clarify Your Single Shot vs. Indwelling Catheter Coding   (November 2011)

Plus: Prepare for changes to 77003, too. Although you won’t report new or revised CPT® codes until January 2012, prepare yourself – and your anesthesia providers – now for revisions that can affect your everyday coding, such as the rewording of two popular epidural codes. Examine the Descriptor Differences The primary changes apply to epidural codes 62310 and 62318. The current and upcoming descriptors are as follows: The new descriptors incorporate several changes: 62310 clarifies that it [...]