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Anesthesia Coding Alert

Anesthesia Basics:
Refresh Your Time Calculation Savvy With These 3 Scenarios
Remember every unit is critical to anesthesia claims success. Time calculation is an inte... Read more
Coding Update:
Get Ready for New CPT® Codes That Could Change Your Reporting in 2020
Tip: Pay special attention if you sometimes report pain management services. Fall is here... Read more
Compliance:
Prepare for Stricter Medicare Provider Enrollment, Thanks to New Rule
CMS will have greater authority to deny or revoke enrollment. The trend toward deregulati... Read more
Reader Question:
Append Modifier QZ for CRNA Without Medical Direction
Question: Our facility does not have an anesthesiologist on staff so relies on CRNAs. A no... Read more
Reader Question:
Turn to E/M Codes in Certain Scenarios Before Induction
Question: A patient with a stab wound to the right chest wall (with hemopneumothorax) was ... Read more
Reader Question:
Include Clear Documentation of Anesthesia During Extubation
Question: Is it possible to charge for an extubation procedure? The surgeon did the extuba... Read more
Reader Question:
Negotiate with Private Payers Before Submitting 95955 with Anesthesia Code
Question: Some anesthesiologists in our area are billing 95955 in addition to the procedur... Read more
Reader Question:
Only Report Z99.11 as a Secondary Diagnosis
Question: Our physician provided anesthesia while another physician inserted a vertebral a... Read more
Reader Question:
Cardiac Bypass Anesthesia Includes +99116 and +99135
Question: Can we code for induced hypothermia and hypotension in addition to anesthesia du... Read more
Reader Question:
C-section and Bowel Repair During Same Session
Question: A patient went to the OR for a C-section due to bowel obstruction. Can we bill f... Read more
You Be the Coder:
Here’s How to Bill Your Teaching Physician’s Service
Question: We currently have a medical student working with us at our clinic. In patient en... Read more
Special Circumstances:
Clarify What Qualifies as ‘Emergency’ Before Coding with +99140
Remember the situation is the determinant, not the location. Certain circumstances can so... Read more
Fee Schedule:
Watch for Little Change to Your CMS Reimbursement in CY 2020
Anesthesia conversion factor remains virtually the same. Changes will soon be afoot for r... Read more
Security:
Follow These 4 Tips—Not the Myths—to Better HIPAA Compliance
Pay prices upfront to avoid bigger costs later. Many practices (or covered entities, CEs)... Read more
You Be the Coder:
Turn to This Code for Single-shot Cervical Epidural
Question: The physician gave the patient a single-level cervical transforaminal epidural t... Read more
Reader Question:
Only Append Modifier 24 for Unrelated Care During Post-op Period
Question: I need some help in figuring out what we can bill for our involvement with post-... Read more
Reader Question:
Be Sure L&D Code Captures the Correct Level of Service
Question: I am coding for a patient who did not have labor analgesic. She did have anesthe... Read more
Reader Question:
Watch Mode of Anesthesia Before Reporting 62322
Question: The anesthesiologist placed a single-injection intrathecal block to interspace L... Read more
Reader Question:
Remember That 64616 Doesn’t Qualify for ‘Bilateral’
Question: When our physicians administer Botox for chronic migraines, we bill the HCPCS J ... Read more
Reader Question:
Choose from G21 Family for Secondary Parkinsonism
Question: I know that certain conditions can affect anesthesia administration, especially ... Read more
Anesthesia Basics:
Don’t Get Muddled Over Moderate Sedation Coding
Keep 4 things in mind when deciding whether you can report the service. Hearing multiple ... Read more
Code Corner:
Choose from These Codes When Reporting Moderate Sedation
Caveat: Have clear documentation that the codes apply. CPT® 2019 includes six codes for ... Read more
Procedure Focus:
Are You Up to Date on TPI Coding? Find Out Before It’s Too Late
Plus: Keep this list of potential associated diagnoses handy. Even if you don't code for ... Read more
Technology News:
CMS Makes a Move to Close Communication Gaps
Here's the scoop on the newest way to share data. The Centers for Medicare & Medicaid... Read more
Reader Question:
Begin With 36902 to Cross to Anesthesia for Dialysis Circuit
Question: What is the correct way to code for anesthesia related to angioplasty on a ... Read more
Reader Question:
‘Unlisted’ Is Your Option for Anesthesia During Nasogastric Tube Placement
Question: I bill for a children's hospital and a small child was brought to the OR and ane... Read more
Reader Question:
Remember That 62263 Covers Multiple Days of Treatment
Question: My physician performed an epidural lysis and administered three injections over ... Read more
Reader Question:
Choose Correctly Between Modifiers QY and QX
Question: I'm coding for a procedure that included an anesthesi­ologist and CRNA. Can you... Read more
Reader Question:
Don’t Try to Bill Anesthesia for Fetus During Mom’s Surgery
Question: An expectant mother was given general anesthesia during a procedure. The fetus (... Read more
Reader Question:
Append Modifier 23 to Explain Unusual Anesthesia
Question: A patient needed general anesthesia during an EEG due to behavioral issues and a... Read more
You Be the Coder:
Submit This Code for Axillary Sentinel Node Biopsy
Question: The surgeon performed an axilliary sentinel node biopsy in conjunction with... Read more
Code Update:
Don’t Let the Latest CCI Edits Slip Past Your Notice
Hint: Pay special attention if you report pain management services. The latest Correct Co... Read more
ICD-10:
Get a First Look at Diagnosis Changes for 2020
Every code can help justify your anesthesia provider's service. The initial information a... Read more
Compliance:
HHS Switches Up Your Potential HIPAA Breach Penalty Fees
Big changes to annual limits are being implemented. In an announcement that shocked provi... Read more
Reader Question:
Management Code 01996 Can Go With Continuous Block Codes
Question: One of our providers asked a question about the daily management codes asso... Read more
Reader Question:
Verify Intrathecal Block’s Purpose Before Coding
Question: Our anesthesiologist administered a single injection intrathecal block duri... Read more
Reader Question:
Remember the Requirements for Moderate Sedation
Question: Our physicians do not normally use moderate sedation, so I'm not accustomed... Read more
Reader Question:
POS 11 Is a Legitimate Place for Anesthesia Services
Question: My anesthesiologist has been asked to perform anesthesia in an office surgi... Read more
Reader Question:
Remember You Can’t Buy HIPAA Compliance
Question: Our office recently purchased encryption software that claims to be “100-... Read more
You Be the Coder:
Know How to Choose Between 01992 and 01936
Question: Is it appropriate to report 01992 with 01936, or are they inclusive of each... Read more
Modifier Refresher, 01999:
Don’t Let ‘Discontinued’ Derail Your Claims
Follow 3 steps to keep modifier 53 claims on the right track. Surgeons and anesthesiologi... Read more
Pain Management:
Get Clear on Diagnosis Options for Spinal Stenosis
Hint: Pay close attention to the specific area affected. Coding for a patient who's been ... Read more
Compliance:
Say Goodbye to 1 Phase of HIPAA Security Programs
‘Phase 2' of the audit program is no longer in effect. After being inundated with HIPAA... Read more
Reader Question:
Check Purpose of Epidural Before Reporting Anesthesia Services
Question: Are we allowed to bill MAC anesthesia for a caudal epidural that was administere... Read more
Reader Question:
Consider 01996 for Postoperative Pain Management Check
Question: Is it appropriate to bill 99231 when our anesthesiologist visits the patient at ... Read more
Reader Question:
Watch for Combination Diagnosis if Multiples Are Denied
Question: A private insurer has denied our claim for a pain management office visit f... Read more
Reader Question:
Make Note of Dates When Anesthesia Service Changes After Midnight
Question: I am billing an OB case that started as a continuous labor epidural for a planne... Read more
Reader Question:
Verify That You’re Selecting the Correct Crosswalk Code
Question: Our physician administered anesthesia while another physician inserted a vertebr... Read more
Reader Question:
01990 Represents Anesthesia Support During Organ Harvest
Question: The anesthesiologist was present when a patient who had been declared brain-dead... Read more
Reader Question:
M62 Family Has Diagnoses for Nontraumatic Biceps Rupture
Question: The anesthesiologist documented “repair of biceps tear” as the procedure per... Read more
You Be the Coder:
Turn to This Code for Anesthesia During Kyphoplasty
Question: One of our doctors is questioning whether 01936 accurately reflects the work of ... Read more
Documentation:
Let Your Diagnoses Help Support Medical Necessity
Watch circumstances and payer policies to bolster your chances. Documentation is always k... Read more
Definition:
Know the Official Stance on Medical Necessity
Get familiar with AMA and CMS viewpoints. According to the American Medical Association's... Read more
Privacy:
Keep Staff Trained to Keep Yourself Free From HIPAA Trouble
Start with clear explanations of what constitutes PHI. Just because the term “HIPAA” ... Read more
Compliance:
Follow 5 Steps to Keep Your MIPS Files on Track
Hint: Old fashioned organization is your key to success. The potential for audits has bee... Read more
Reader Question:
Search for a Primary Diagnosis to Report With Z99.11
Question: Our anesthesiologist provided anesthesia while another physician inserted a vert... Read more
Reader Question:
Spinal Anesthesia Outranks Intrathecal Injection In Terms of Coding
Question: The anesthesiologist administered an intrathecal morphine injection in conjuncti... Read more
Reader Question:
Code 01936 Is Probably Best for Anesthesia During Kyphoplasty
Question: One of our doctors is questioning whether 01936 accurately reflects the work of ... Read more
Reader Question:
Know Your Best Options for Anesthesia During TEE
Question: I have a CRNA who wants to bill 93318 for his part in a TEE procedure, but anoth... Read more
Reader Question:
Procedure Code Overrides Intubation and Vent Management
Question: The anesthesiologist intubated a patient, performed ventilation assistance/manag... Read more
You Be the Coder:
Append the Correct Modifier for CRNA’s Work
Question: Our CRNA documented that she administered an epidural steroid injection under an... Read more
Procedure Focus:
Follow This Refresher to Smoother GI Endoscopy Claims
Don't forget to factor in the MAC possibility. Coding for anesthesia during gastrointesti... Read more
Policies:
Brush Up on Medical Necessity for MAC
Check out this payer's example of criteria to meet. Although colonoscopy screening is a p... Read more
Compliance:
Strengthen Your Security Against Ransomware Attacks
Tip: Even simple staff training can help make a difference. If you think your practice is... Read more
Compliance:
Get Your Latest CMS News Via Podcast
Feds continue to go mainstream with information sharing. If you're a podcast fan, you now... Read more
Reader Question:
Check Line Placement to Correctly Code Central Line With Swan-Ganz
Question: Our anesthesiologist recently documented that we should code for a central line,... Read more
Reader Question:
Report 64555 for Trial Occipital Nerve Stimulator
Question: Our pain management specialist placed a dual 8-electrode occipital stimulator su... Read more
Reader Question:
Don’t Try to Find a Code for MAC
Question: I'm new to anesthesia coding and have heard quite a bit about monitored anesthes... Read more
Reader Question:
Diagnosis M51.16 Covers the Symptoms of M51.26
Question: A payer has denied our claim for a pain management office visit with the reason ... Read more
Reader Question:
Watch Your Claims for Anesthesia During TEE
Question: Are there new coding edits associated with billing 93312, 93320, and 93325 for a... Read more
You Be the Coder:
Allocating Time Units Between Providers
Question: A non-medically directed CRNA took the patient into the operating room. He place... Read more
Coding 101:
Remember the Rules for Reporting Field Avoidance
Hint: It's all about the number “5.” Accounting for field avoidance might not be in y... Read more
Coding Edits:
Don’t Miss Out on Payment for Spinal Arthrodesis
Pay special attention to spaces and incision sites. The newest round of Correct Coding In... Read more
Compliance:
Do You Watch These 5 Areas for Audit Assurance?
Auditing is a necessity in the health care and coding world, whether you're a provider or ... Read more
Reader Question:
Report O34.219 for Repeat C-section
Question: A patient had a repeat Cesarean section due to pre-eclampsia. What is the c... Read more
Reader Question:
Paravertebral Facet Joint Injection Could Be 64490
Question: Our pain management specialist administered a cervical facet zygopophyseal intra... Read more
Reader Question:
Turn to These Modifiers When Reporting Medical Direction
Question: I'm still fairly new to anesthesia coding and want to be sure I'm adding the cor... Read more
Reader Question:
Code 76942 Has No Anesthesia Crosswalk
Question: One of our anesthesiologists insists there is an ASA code valued at one base uni... Read more
Reader Question:
Generally Say ‘No’ to Providing Anesthesia for Dental Procedures
Question: Can an anesthesiologist provide dental anesthesia for procedures such as dental ... Read more
Reader Question:
C-section Diagnosis Code Depends on First Time or Repeat
Question: I am billing for providers who only administer obstetrical anesthesia. What... Read more
You Be the Coder:
Choose From These Codes for Anesthesia During Colonoscopy
Question: Our CRNA was asked to provide anesthesia during a patient's colonoscopy. How do ... Read more
Postoperative Coding:
Survey These Scenarios to Score Success With Daily Hospital Management
Once again, documentation will make or break your claim. You can report postoperative ser... Read more
Pain Management:
Keep These Tips in Mind for Post-op Pain Care Coding
Pay attention to laterality and other factors. Code 01996 (Daily hospital management of e... Read more
Practice Management:
Follow 4 Tips for Self-Audit Success
Start by spotting possible trends, then expand from that point. Now that you're a couple ... Read more
MAC Update:
New LCD Rules Could Be in the Works
Check out this website for the latest info. Think you have a solid understanding of the L... Read more
Reader Question:
Reserve +64484 for Different Level of ESI
Question: I have some questions about billing for epidural steroid injections. Patient #1 ... Read more
Reader Question:
Episiotomy Work Is Included In L&D Epidural Code
Question: The anesthesiologist administered an epidural during a vaginal delivery. He foll... Read more
Reader Question:
Submit ‘Unlisted’ 64999 for Internal Pump Repositioning
Question: A patient has an implanted pain pump. She is not due for a replacement, but want... Read more
Reader Question:
Pay Attention to Guidance When Choosing Between 62322 and 62323
Question: What is the correct way to report a caudal ESI under ultrasound guidance? I'm co... Read more
Reader Question:
Payers Might Be Looking for Higher Level Comorbidities
Question: During a recent audit in our department, I was marked down for having too many d... Read more
You Be the Coder:
Pinpoint the Correct Arthroplasty Code
Question: Our pain management physician performed arthroplasty of a patient's finger joint... Read more
Coding Changes:
The First Coding Edits of 2019 Include 46,000 New Pairs: Are You Ready?
Tip: Focus on 99451 and 99452 and you'll be fine. Each year begins with a new set of Corr... Read more
Descriptor Check:
Do You Know What 99451 and 99452 Represent?
Here's your short answer. With so many CCI edits tying in with codes 99451 and 99452, it'... Read more
Reimbursement Update:
CMS Boosts Your Pay – Slightly – With 2019 Conversion Factors
The anesthesia starting point will be $22.2730. Anesthesia providers will see an uptick i... Read more
Pain Management:
Don’t Settle for the Simple ‘Pain’ Diagnosis
General is fine for a starting point, but be prepared to shift. Coding for pain syndromes... Read more
Reader Question:
Submit a Single Code, Even for Different Types of Anesthesia
Question: The anesthesiologist provided an epidural for a vaginal delivery, followed immed... Read more
Reader Question:
Here Are Your Options for Failed VBAC Followed by C-section
Question: A patient attempted a VBAC delivery but it failed due to fetal distress. She del... Read more
Reader Question:
Code 00300 Applies to Baer Hearing Study
Question: What is the appropriate anesthesia code for a Baer Hearing Study? Delaware Subs... Read more
Reader Question:
Only Bill 93503 When Swan-Ganz and Central Line Share Access Point
Question: One of our anesthesia providers asked me about how to code this scenario: Someon... Read more
Reader Question:
Timing Is Crucial for Discontinued Procedures
Question: Our anesthesiologist was scheduled to administer anesthesia during hardware plac... Read more
You Be the Coder:
Crossing Mediport Placement to Anesthesia
Question: I'm coding for a patient with breast cancer (C50.912, C77.3) who received a Medi... Read more
Coding Basics:
Start the New Year With a Firm Grasp of Medical Direction vs. Supervision
Hint: It's all about following the ‘7 rules.' One of the primary factors to consider wh... Read more
ICD-10:
Focus on These Terms to Pinpoint Best Migraine Diagnosis
Remember, all symptoms don't lead to the same code. The detailed specificity of ICD-10 is... Read more
Reader Question:
Screening Designation Separates 00811 and 00812
Question: There is some confusion in our office about which anesthesia code we should use ... Read more
Reader Question:
Report Intubation Over Vent Management
Question: Can we bill Medicare for intubation (31500), ventilation assist/management (9400... Read more
Reader Question:
Code Only Epidural During Session That Includes MAC
Question: Our physician administered an epidural for a vaginal delivery, followed immediat... Read more
Reader Question:
Transforaminal Injection Code Overrides IV Sedation
Question: Our physician performs medial branch blocks and transforaminal injections in our... Read more
Reader Question:
Epidural Removal Time Is Individualized
Question: What amount of time should we include on the claim for epidural removal followin... Read more
Reader Question:
Check Patient Position When Choosing Between 01991 and 01992
Question: Which is the best anesthesia code for an SI joint injection? Wyoming Subscriber... Read more
Reader Question:
Watch the Elapsed Time Before Coding Repeat Injection
Question: Our pain management specialist saw a patient with complex regional pain syndrome... Read more
You Be the Coder:
The Difference Between 01935/36 and 01991/92
Question: Can you explain to me when I should report codes 01935/01936 and 01991/01992? Ou... Read more