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Anesthesia Coding Alert

Boost Revenue:
Know When Line Placements Can and Cannot Be Billed Separately
Swan-Ganz, A-lines, IVs, central venous catheter placements (CVP) these are all types of ... Read more
Optimize Reimbursement for Spinal Endoscopy
New procedures and techniques are constantly being added to the field of medicine. And a... Read more
Get Paid for Pain Services in Light of New APC Regulations
Ambulatory payment classifications (APCs) finally went into effect Aug. 1, amidst much con... Read more
Reader Question:
Blood Patch Epidural
Question: A patient presents at the emergency department (ED) with a post spinal procedure... Read more
Reader Question:
Anesthesia Assistants
Question: Are you familiar with written protocol regarding anesthesia assistants (AA)? The... Read more
Reader Question:
Nasal Intubation
Question: What is the correct CPT code for nasal intubation? Maryland Subscriber A... Read more
Reader Question:
Anesthesia for Procedures on Eye
Question: Is the Medicare allowance for code 00142 (anesthesia for procedures on eye; lens... Read more
Reader Question:
Double Lumen Hickman Catheter
Question: How should we charge for a double lumen Hickman catheter? I want to use 36533,... Read more
You Be the Coder:
TIPS Procedure
Question: What is the best code for a TIPS procedure (transjugular insertion of a portal-... Read more
Take a Sneak Peek at New CPT 2001 Codes for Anesthesia Providers
Note: Please consult CPT 2001 for final and complete information. The codes listed in th... Read more
Learn Billing and Coding for ICU Care
Anesthesia care is often finished once the patient officially transfers from the care of... Read more
Correction
In You Be the Coder of the September issue (page 70), the answer stated in part that Med... Read more
Reader Question:
Nissen Fundoplication
Question: I have to code the anesthesia portion of a complicated surgery. The patient orig... Read more
Reader Question:
Foreign Body Removal
Question: How do you charge for 67938 (removal of embedded foreign body, eyelid) with a lo... Read more
Reader Question:
Laryngoscopy
Question: When doing a direct fiberoptic laryngoscopy (31575, laryngoscopy, flexible fiber... Read more
Reader Question:
CT Scan With Biopsy
Question: Should we use a modifier when billing for a CT scan with biopsy? The CPT code is... Read more
Reader Question:
Pulse Oximetry Monitoring
Question: Can you include pulse oximetry monitoring (94760, noninvasive ear or pulse oxime... Read more
You Be the Coder:
Neuroma
Question: A patient presented to our office with a possible neuroma of the right lower l... Read more
Get Paid for Post-procedure Pain Management
Many patients who undergo serious surgical procedures like total knee replacement (27447,... Read more
New E/M Guidelines Designed To Simplify Documentation
One of the biggest coding news items for the summer and fall was the introduction of new e... Read more
Heads Up for New ICD-9 Codes Becoming Official Oct. 1, 2000
The Health Care Financing Administration (HCFA), like many other organizations last year,... Read more
Reader Question:
Thrombolysis
Question: What is the code for thrombolysis of the lower extremity for deep vein thrombosi... Read more
Reader Question:
Epidurals
Question: Which CPT codes does Medicare consider to be payable with modifier -59, and whic... Read more
Reader Question:
Interscalene Blocks
Question: Can I bill for interscalene blocks in addition to general anesthesia? The blocks... Read more
You Be the Coder:
Transplants
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Code for New IDET Procedure to Get Best Reimbursement
The Federal Drug Administration (FDA) cleared IntraDiscal Electrothermal Therapy (IDET) ... Read more
Avoid Audits! Use Codes 99214 and 99233 Only When Merited
The Health Care Financing Administration (HCFA) is watching providers usage of evaluatio... Read more
Increase Pay Up for Pain Management Spinal Injections
Spinal injections for pain management can be used in many situations and at a variety of l... Read more
Reader Question:
Triple Lumen Catheter
Question: When coding for hyponatremia, hypovolemia and pulmonary congestion, our client s... Read more
Reader Question:
Daily Management
Question: Can an anesthesiologist who places an epidural catheter post-op and provides dai... Read more
Reader Question:
Pre-op Evaluations
Question: We have a podiatrist who comes to our facility to perform procedures. He cannot ... Read more
Reader Question:
Fluoroscopic Guidance
Question: Does a separate report have to be dictated before you can bill a procedure as 76... Read more
You Be the Coder:
Endoscopy
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
What's New on Getting Paid for Pain Management Services in ASCs?
Ambulatory surgical centers (ASCs) have been experiencing problems getting paid for pain m... Read more
Get Reimbursed for Pain Procedures Using Modifier -50
Adjusting to updated codes and guidelines in CPT Codes each year can be challenging for ... Read more
Code for Bone Procedures to Get Best Reimbursement
A number of surgical codes are included in CPT 2000 for special bone procedures requirin... Read more
Reader Question:
E/M Codes 99241-99245
Question: Can we use evaluation and management (E/M) codes 99241-99245 (office or other ou... Read more
Reader Question:
Removal of CVP Line
Question: Which code is appropriate for removing a central venous (CVP) line when it is do... Read more
Reader Question:
Epidural Injection
Question: When a physician performs an epidural injection at T12-L1 level, a thoracic face... Read more
Reader Question:
Extubation
Question: Is there an appropriate way to bill an extubation? There is no CPT code, but t... Read more
Reader Question:
Code 10999
Question: How should I code for anesthesia during an electroencephalogram (EEG)?Michigan S... Read more
You Be the Coder:
Seven Rules of Medical Direction
Question: In our anesthesiology practice, we medically direct certified registered nurse a... Read more
Medical Supervision Versus Medical Direction:
Know the Specifics to Increase Pay Up
There are three ways to bill for an anesthesiologists services: as personally performed,... Read more
Optimize Reimbursement for Pain Management Consults
Almost 30 pages of CPT Codes 2000 are dedicated to codes used to report evaluation and m... Read more
Reader Question:
Nerve Block
Question: Ive never been clear on whether you can bill for a nerve block for cataract surg... Read more
Reader Question:
Charging by Time
Question: Our time unit for anesthesia services in California is 15 minutes. Our computer ... Read more
Reader Question:
Acid Check
Question: What code should I be using for anesthesia during an acid check? Cheryl Pascale,... Read more
Reader Question:
Regional Anesthesia
Question: What is the definition of regional anesthesia, medically speaking and from a cod... Read more
You Be the Coder:
Coronary Artery Bypass Graft
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Get Payment for Canceled Surgeries
Its a rather common scenario for anesthesia coders a case is canceled or postponed, and ... Read more
Case Study:
Optimize Reimbursement For Endovascular Coiling
Although many patients undergo diagnostic procedures without anesthesia, circumstances o... Read more
Document Training and Service To Get Reimbursed for TEE
"Billing for transesophageal echocardiography (TEE) is one of the gray areas of ane... Read more
Maximize Payment for Fiberoptic Intubation
Fiberoptic intubation can be used for any type of surgery when the anesthesiologist feel... Read more
Reader Question:
Intraoperative Neurophysiology
Question: How should I bill for intraoperative neurophysiology monitoring and somatosensor... Read more
Reader Question:
Modifier -AD
Question: I have a two-part question about medical supervision and using the -AD modifier.... Read more
Reader Question:
Venipuncture
Question: We have been using code 36410* (venipuncture, child over age 3 years or adult, n... Read more
Reader Question:
Sacroiliac Injections
Question: I know that two new codes for sacroiliac injections went into effect this year a... Read more
You Be the Coder:
Cataracts
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Documentation is Key to Reimbursement for Nonstandard PACU Care
Nugget: Thorough documentation can help you get reimbursed for PACU time that goes beyond ... Read more
Optimize Pay When Anesthesia Plan Changes
Nugget: Knowing which type of anesthesia is providednot just the type that is plannedis th... Read more
Use Modifier -25 Appropriately to Increase Revenue
Nugget: Anesthesiologists can use modifier -25 to increase reimbursement in the appropria... Read more
Office-based Anesthesia:
Get Paid for Involvement in the OBA Trend
Nugget: Before performing office-based anesthesia procedures, anesthesiologists should v... Read more
Reader Questions:
'Start Up' Fee
Question: The anesthesiologist in our physician group states that there is a start up fee ... Read more
Reader Questions:
Emergency Delivery
Question: Some of our physicians assist with deliveries at a local hospital with a huge ob... Read more
Reader Questions:
Medical Supervision
Question: Please explain the Medicare billing rules concerning the medical supervision of ... Read more
You Be the Coder:
Epidural Drug Infusion
Question: Our anesthesiologist provided general anesthesia when a surgeon performed proced... Read more
Increase Pay Up For Pain Management Codes
The pain management codes were completely restructured in CPT 2000 (see Optimize Reimburse... Read more
Know Medicare Modifiers For Optimal Reimbursement
Modifiers are an integral part of coding for anesthesia practices. Some, such as physical ... Read more
Reader Question:
Pre-op Exam
Question: Is there anything in writing somewhere that specifically mandates what an anesth... Read more
Reader Question:
Nerve Blocks
Question: Can you offer any advice on billing for nerve blocks for post-op pain control ... Read more
Reader Question:
Alternative Therapies
Question: I am a nurse in private, independent practice, and am board certified in pain ma... Read more
Reader Question:
Labor Epidurals
Question: Labor epidurals are so common, but it seems like our practice is always getting ... Read more
Optimize Reimbursement for Tricky New Pain Management Codes
Although a new system of pain management codes has been in effect for more than a month no... Read more
Get Paid for Procedures That Lack Codes
Surgery equipment and procedures are changing so quickly that the CPT is not able to keep ... Read more
Avoid Fraud:
Correctly Interpret HCFA Medical Direction Rules
The Health Care Financing Administrations (HCFA) rules for medical direction of nurse an... Read more
Reader Question:
Procedures and Supplies
Question: When you bill for an epidural or a paraspinal single injection, do you bill only... Read more
Reader Question:
Coding for Nurses
Question: Our practice group includes both anesthesiologists and certified registered nur... Read more
Reader Question:
Software for Discontinuous Time
Question: Now that the Health Care Financing Administration (HCFA) officially has approved... Read more
Reader Question:
Endotracheal Tubes
Question: The anesthesiologists in our group bill for endotracheal tubes for obese patient... Read more
Reader Question:
Epidural Placements
Question: Our group has CRNAs who are responsible for epidural placements. Should we bill ... Read more
Reader Question:
Floroscopic Guidance
Question: Is it appropriate to bill 76000 (fluoroscopy [separate procedure], up to one hou... Read more
Correctly Coding for Post-op Pain Blocks
The reimbursement process for post-op blocks administered to manage the pain that follows ... Read more
HCFAs Final Ruling Sanctions Billing for Discontinuous Time
Documenting time will be critical now that the Health Care Financing Administration (HCFA)... Read more
Attention to 10 Key Areas Improves Documentation
Complete documentation for anesthesia relies on 10 basic must haves including correct use ... Read more
News Brief:
Getting Help with Medicare Reimbursement Appeals
The Provider Reimbursement Review Board, an independent panel established by the Medical G... Read more
Reader Question:
Post-op Pain Control
Question: If general anesthesia is administered and an epidural catheter is placed for po... Read more
Reader Question:
Use of Modifiers for Medicare
Question: I understand that Medicare does not allow specific modifiers regarding age, heal... Read more
Reader Question:
Incomplete Medical Direction
Question: We have five physicians and two Certified Registered Nurse Anesthetists (CRNAs) ... Read more
Receive Justified Payment for Multiple Outpatient Procedures on the Same Day
Its not uncommon for patients to undergo many diagnostic or therapeutic procedures on an o... Read more
Correct Usage of Modifiers Can Optimize Reimbursement
Keeping track of modifiers can be confusing because some modifiers (such as - 58, -78 and... Read more
Determining When to Bill for Patient-controlled Analgesia
A common pain-management trend is to allow patients to control the amount of analgesia t... Read more
Correction:
Medical Direction is Personally Performed
In the article Frequently Asked Questions for Billing Medical Direction Cases on page 6 o... Read more
Reader Question:
Coding LEEP
Question: Which code is best to use for LEEP, and why? 57520 or 57522?Anonymous Texas Subs... Read more
Reader Question:
Bone Growth Stimulator
Question: Which codes should you use for bone growth stimulator insertion and removal?Anon... Read more
Reader Question:
Duramorph Billing
Question: What is the correct way to bill for an epidural or intrathecal narcotic (Duramor... Read more