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Anesthesia Coding Alert

CPT 2012:
62310, 62318 Revisions Help Clarify Your Single Shot vs. Indwelling Catheter Coding
Plus: Prepare for changes to 77003, too. Although you won't report new or revised... Read more
Post-Procedure Care:
Manage Your 01996 Reporting Correctly: Real World Scenarios Show You How
LCDs and other resources to help you determine when 01996 is legit. The descriptor for... Read more
News Flash:
Modifier AA Could Bring You Extra Pay for CAH Services in 2012
Check the updated guidelines if you bill anesthesia services on behalf of a critical acc... Read more
New K38 Choices Will Expand Appendicitis Specificity
Watch for 'other' versus 'unspecified' options. When your anesthesiolo... Read more
Reader Question:
Only Report 20610 With 27093 in Special Circumstances
Question: Our pain management physician sometimes performs a hip arthrogram and hip inject... Read more
Reader Question:
Include AD for Maxed Concurrent Cases
Question: What are the current Medicare rules when our anesthesiologist bills more than fo... Read more
Reader Question:
Patient's Position Determines 01991 or 01992
Question: Our anesthesiologist sometimes performs anesthesia for a pain management physici... Read more
Reader Question:
Placement Clues You to Central Line With Swan-Ganz
Question: Our anesthesiologist recently documented that we should code for a central line,... Read more
Reader Question:
Keep 64612 or 64613 to Single Unit, Not Bilateral
Question: When our physicians administer Botox for chronic migraines, we bill the HCPCS J ... Read more
Reader Question:
Intent Helps Distinguish SI Injection From Arthrogram
Question: What is the difference between a sacroiliac (SI) joint injection and an SI joint... Read more
Reader Question:
Turn to Q5 for Vacation-Coverage Billing
Question: One physician from our group covered another physician's days while he went on v... Read more
You Be the Coder:
Deciding Time Between CRNA and Anesthesiologist
Question: A non-medically directed CRNA took the patient into the operating room. He place... Read more
Cardiac Anesthesia:
Clarify CABG Coding With 4 Do's and Don'ts
Tip: Surgeon's documentation can also help your coding accuracy. When coding for anesthesi... Read more
Pain Management Corner:
Follow Treatment Site to Find Correct Codes for Trigeminal Neuralgia
Tip: Narrow anatomy options to simplify code selection.When your pain management specialis... Read more
ICD-10 Prep:
Focus on A&P When Prepping for ICD-10 Conversion
Analyze your practice's top 30 diagnoses to get a head start toward compliance.Education i... Read more
Prepare for More Detailed DVT Code Choices With I82.4-
Check all records for documentation of right, left, or bilateral.ICD-10 will bring code ch... Read more
Reader Question:
Yes, You Can Report 77003 With 62311
Question: Medicare denies our claim when we bill 62311, 77003, and 64483 together. The phy... Read more
Reader Question:
Code Line Placement Even if Standby Won't Fly
Question: The anesthesiologist placed an IV for saline and monitored the patient's vital s... Read more
Reader Question:
Verify Whether Multi-Service Claim Needs -59
Question: A patient came to the office for treatment of L3 radiculitis and ankylosis. The ... Read more
Reader Question:
Multiple 01992 Is Allowed for Multiple Providers
Question: One of our providers is billing 01992-QY and 01992-QX for a diagnostic spinal in... Read more
Reader Question:
Submit 01936 for Lumbar RFA
Question: What anesthesia code should we report when a patient receives MAC (monitored ane... Read more
Reader Question:
Verify Local Policy for Medical Direction Sign-Offs
Question: I've reviewed Medicare guidelines for medical direction documentation, but our c... Read more
You Be the Coder:
Crosswalk Confusion for 64483
Question: We crosswalked 64483 to anesthesia code 01992, but the payer denied our claim.... Read more
Dental Care:
Zero In On Payer Preferences Before Coding Anesthesia for Dental Cases
Hint: Focus on the medical -- not the dental -- payer. Many patients have separa... Read more
Gastro Focus:
Scope Out 4 Steps to Simplify Gastro Anesthesia Coding
Supporting medical necessity and checking policies help clear the way. If your anesthesiol... Read more
Nail Down Common Acronyms to Code More Accurately
Test yourself to see how well you interpret these abbreviations. If the charts you code fr... Read more
Twin Delivery Code Choices Multiply With ICD-10
Watch the trimester and "O" versus "0" for successful coding.If a chart crosses your desk ... Read more
Reader Question:
Support 01996 With Daily Notes, Correct Administration
Question: What are the latest documentation requirements for reporting daily hospital mana... Read more
Reader Question:
Filing Details Can Help 01967/+01968 Claims
Question: The anesthesia provider administered an epidural for pain management during a pa... Read more
Reader Question:
Tibial Spine Avulsion and Arthroscopic Repair
Question: What surgical and anesthesia codes apply to an arthroscopic repair and tibial sp... Read more
Reader Question:
Skip Billing Lidocaine With Block or Injection
Question: Our physicians often use a local anesthetic or a mixture of triamcinolone and li... Read more
Reader Question:
Choose 95990 for PA Pump Refill Work
Question: How do we report the service when a physician assistant completes a pump refill?... Read more
Reader Question:
Cookie cutter appeal letters won't bring in cash
Question: After checking to be sure we haven't made a coding or billing entry error, our p... Read more
You Be the Coder:
Coding Anesthesia for Lumbar Wound Dehiscence
Question: Our anesthesiologist provided general anesthesia during a lumbar wound dehiscenc... Read more
CCI 17.2:
Think Twice Before Reporting Neonatal Hypothermia During Heart Procedures
Latest CCI edits weigh in on hypothermia, disallow certain HCPCS codes with joint, somat... Read more
2012 Code Changes:
Watch for Expanded Neoplasm, Personal History Codes That Dominate 2012 ICD-9 Updates
Plus: Migraine revisions focus on punctuation addition, not descriptor change.New and revi... Read more
Pain Management:
Adding Modifiers 25, 50, or 59? Check for Correct Circumstances
Knowing which modifier to append -- and when -- can help your injection claims... Read more
Previous C-Section Delivery Will Change to O34.21 in ICD-10
Tip: Be careful not to confuse "O" with "0". When ICD-10 codes goe... Read more
Reader Question:
Document Before Cross Coding 62310, 62311, 64483
Question: What anesthesia codes should we cross to for injections 62310, 62311, and 64483?... Read more
Reader Question:
T12-L1 Interlaminal Epidural Leads to 62310
Question: Our pain management specialist administered an interlaminar epidural injection... Read more
Reader Question:
Pump Oxygenator Clues You to 00562 or 00566
Question: Our anesthesiologist used a pump oxygenator during a coronary artery bypass graf... Read more
Reader Question:
Medical Direction Classification Stays Throughout Case
Question: Anesthesiologist A medically directed a CRNA during the first portion of a Medic... Read more
Reader Question:
Remember Face-to-Face in New vs. Established
Question: We saw a patient for pain injections earlier in the year and he is now coming ... Read more
You Be the Coder:
Splitting Locum Duties Between 2 Providers
Question: I know that CMS allows you to use locum tenens providers after a physician lea... Read more
Monitored Care:
Coding MAC? Verify Whether Payer Wants QS or G8/G9 on the Claim
Modifiers give more details, but not extra pay.Your monitored anesthesia care (MAC) coding... Read more
Remember Distinctions Between MAC and Other Anesthesia
Hint: Watch consciousness, not just airway.Monitored anesthesia care (MAC) is a specific a... Read more
Pain Management:
4 Common Interventional PM Procedures You Can't Afford To Miss
Get the lowdown on when to code separately for fluoroscopy.If your physician performs inte... Read more
Avoid EHR Penalties With These Proposed Additional Exemptions
Check whether your group might fall into one of four new categories.The push toward e-pres... Read more
Watch for New Fibromyalgia Diagnosis Choice in 2013
ICD-10 establishes separate fibromyalgia, myalgia, and myositis codes.If your providers di... Read more
Reader Question:
Using Existing Epidural Means You Only Bill Time
Question: The obstetrician placed an epidural for labor and delivery, but the patient need... Read more
Reader Question:
Add 5 Units When Claims Shift From 00630 to 00670
Question: A fellow coder told me that we can now bill the 00670 instrumentation code for m... Read more
Reader Question:
322.9 Covers Meningitis With No Other Details
Question: Our physician placed a spinal drain for spine exposure during a thoracic aneurys... Read more
Reader Question:
Opt for Higher Base for Multiple Hernias
Question: A patient had two ventral hernias, one in the mid-abdomen and the other in the l... Read more
Reader Question:
Rely on Units to Report Extra L/D Minutes
Question: When billing for code 01967, sometimes the time is over 999 minutes. In one case... Read more
Reader Question:
Select 20610 for Trochanteric Bursa Injection
Question: How should I code injection of trochanteric bursa and sacral crest? My physician... Read more
You Be the Coder:
Choosing for Tympanostomy Anesthesia
Question: I'm looking for the anesthesia code for a tympanostomy of the left ear, pe... Read more
Take These 3 Steps to Keep Discontinued Procedure Claims Moving
Documentation and timing of cancellation make or break modifier 53.When your anesthesiolog... Read more
3 Scenarios Show When to Rely on Modifier 53
Patient safety is the deciding factor for "Discontinued procedure."The anesthesiologist or... Read more
Medical Direction:
Test Your Concurrency Know-How With 3 Common Scenarios
Let payers reduce your case units instead of handling it yourself.A prime factor in determ... Read more
G89 Family Will Bring Chronic, Acute Pain Options
Hint: One-to-one cross from ICD-9 eases transition. When ICD-10 goes into effect in Oc... Read more
Accounts Receivable:
Improve Your Collections by Boosting Your A/R Process With These 3 Tips
Be diligent with denial follow-ups, or risk leaving money on the table.Economic uncertaint... Read more
Reader Question:
Failed Labor Means 01967, 660.63
Question: Our anesthesia provider was called in to administer an epidural for a labor and ... Read more
Reader Question:
Location Guides Myelomeningocele Repair Choice
Question: Our anesthesiologist provided care during a myelomeningocele repair. I have no i... Read more
Reader Question:
Steer Clear of Modifier PT for Anesthesia
Question: Can you tell me about the new modifier PT? Can we use it when providing anesthes... Read more
Reader Question:
Procedure Includes Bupivicaine Anesthetic
Question: How should we code for bilateral greater occipital nerve blocks with 1.5 cc of b... Read more
Reader Question:
Bulbar Block, Anesthesia Not Same
Question: We have a new anesthesiology client who works in an eye center. He says that he ... Read more
Reader Question:
Post-op Epidural Block Merits 62319
Question: Our anesthesiologist inserted a lumbar epidural catheter to manage post-op pain ... Read more
Reader Question:
Report Extra L/D Time With Units, Not Minutes
Question: When billing for code 01967, sometimes the time is over 999 minutes. In one case... Read more
You Be the Coder:
Coding for Patient Refusal
Question: After placement of an intra-arterial catheter (A-line) in the operating room (OR... Read more
GI Procedures:
Remember One Simple Code to Help Justify Anesthesia for Colonoscopy
Including supporting documentation can also help your cause.ICD-9 Codes 2010 introduced a ... Read more
CCI 17.1:
Report Codes 36620, 93503 Over Paravertebral Facet Joint Injections
Latest CCI edits also classify plantar injections as comprehensive procedures.When your an... Read more
Pain Management:
Follow 2 Simple Tips for Trigeminal Nerve Block Success
Heads up: Watch for other names that could mean trigeminal.If your physician administers t... Read more
Expand Your Cubital Tunnel Syndrome Options With ICD-10
Tip: Clarify MD's notation of CTS before coding.You currently have a single diagnosis choi... Read more
Reader Questions:
Code With +99135 for Controlled Hypotension
Question:One of the anesthesiologists we code for wants to bill for controlled hypotension... Read more
Reader Questions:
Watch Location to Choose Between 01210 and 01230
Question:When is it appropriate to use anesthesia code CPT 01230 versus 01210?Nebras... Read more
Reader Questions:
Report Units, Not Separate Lines, for MC Injection Claims
Question:The physician administered transforaminal epidural steroid injections to the righ... Read more
Reader Questions:
OR Report Will Point to 00472 or 00540 for Pectoralis Flap Closure
Question:The anesthesia record documents a pectoralis flap reconstruction that included de... Read more
Reader Questions:
Modifier Q6 for Locum Tenens Is Only for MD
Question:What is the rule for billing CRNA services as locum tenens?Florida Subscriber Ans... Read more
Reader Questions:
Look to 20550 for Iliotibial Injection
Question:Our physician administered an iliotibial injection with steroids. How should we c... Read more
Reader Questions:
Phone Chat Doesn't Always Mean 99441-99443
Question:A new patient came to our office, and the physician did a complete workup, result... Read more
Reader Questions:
Steer Clear of Modifier PT for Anesthesia
Question:Can you tell me about the new modifier PT? Can we use it when providing anesthesi... Read more
Reader Questions:
Payers Might Have Specific Bundling Issues
Question:Sometimes I cannot find my two code pair in the CCI edits. How do I know which co... Read more
Reader Questions:
Procedure Includes Bupivicaine Anesthetic
Question:How should we code for bilateral greater occipital nerve blocks with 1.5 cc of bu... Read more
You Be the Coder:
Remember Diagnosis to Support 62311 Post-Op
Question:Our state's Medicaid carrier denies our claims when we submit CPT 62311 with modi... Read more
Diagnosis Coding:
High BMI Can Contribute to More Complicated Anesthesia
New code choices could support higher coding, but don't assume you need -22.This year's ne... Read more
Unlock Payment for Unlisted Procedures With Pre-Authorization
Start documenting before the procedure to help win the bottom line battle. Selecting t... Read more
Pain Management:
Say Good-Bye to Bilateral Charges for Chemodenervation
Plus: Add this new botulinum drug to your coding toolbox.The Medicare Physician Fee Schedu... Read more
C-Section Diagnosis 669.71 Becomes O82 With ICD-10
Check out your future fall-back code for cases without indications noted.As much as it mig... Read more
Reader Questions:
Submit 01922 for Intubation During CT Scan
Question: Our anesthesiologist sedated and intubated an autistic adult before she underwen... Read more
Reader Questions:
Vascular Access Separates +76937 From 76942
Question: The anesthesiologist placed a line and used ultrasound guidance during the proce... Read more
Reader Questions:
Convert to Units for Reporting More Minutes
Question: When billing for code 01967, sometimes the time is over 999 minutes. In one case... Read more
Reader Questions:
Select 64449 for Lumbar Catheter Placement
Question: Our anesthesiologist placed a catheter for anesthetic at the lumbar plexus, and ... Read more
Reader Questions:
Verify Extubation for Switch-Over Case
Question: Upon emergence, a hernia repair patient experienced cardiac arrest, so staff beg... Read more
Reader Questions:
Choose J1020, J1030, J1040 Based on Strength
Question: Depo-Medrol comes in three different strengths, but the code doesn't state how m... Read more
Reader Questions:
Procedure Includes Bupivicaine Anesthetic
Question: How should we code for bilateral greater occipital nerve blocks with 1.5 cc of b... Read more
You Be the Coder:
Ureter Location Dictates Lithotripsy Code
Question: Which anesthesia code should we use for lithotripsy or laser of ureteral calculu... Read more
Qualifying Circumstances:
Turn to +99140 for True Emergencies: Tips Help You Decide
Watch 3 areas before expecting 2 extra units for emergency reporting.Reporting any qualify... Read more
Do Your Providers Meet Signature Requirements on Their Charts?
Answers to 2 common questions help ensure you're on track.Including provider signatures is... Read more
Clip and Save:
Use This Handy Chart to Remember What Equals a Signature
Steer clear of stamps.Learning the ins and outs of what constitutes a compliant handwritte... Read more
Pain Management Coders, Prepare for More Acquired Spondylolysis Options
Catch-all code 738.4 to split into multiple diagnoses. ICD-10 Codes implementation in... Read more
Use 64448 for Postop Femoral Catheter, But Not 01996
Check into daily management codes for follow-ups.Thanks to a sharp-eyed subscriber who spo... Read more
Eye Procedures:
Check Provider's Role Before Coding Retrobulbar Blocks
The anesthesiologist's involvement points you in the right direction. Coding your ... Read more
Reader Questions:
Verify New Insurance Before Appointment Time
Question: How should I file a claim on a pain clinic patient who has new coverage but has ... Read more
Reader Questions:
Evoked Potentials Can Merit Modifier 22
Question: The physician performed motor evoked potentials during back surgery that our ane... Read more
Reader Questions:
Consider Diagnosis When Deciding on Anesthesia With Injection
Question: When we have a team of anesthesiologists working together during injection pro... Read more
Reader Questions:
Payer Guidelines Dictate Multilevel Reporting
Question: When billing for multilevel radiofrequency, we report 64622 for the first leve... Read more
Reader Questions:
Submit 20605 or 22899 Bertolotti Joint Injections
Question: Our pain management specialist performed a left medial branch block at the L5 ve... Read more
You Be the Coder:
Modifier QZ Can Be Removed From Some Secondary Claims
Question: One of our secondary insurance carriers denies claims we submit with modifier QZ... Read more
Line Placement:
5 Keys Unlock Your Invasive Lines Documentation Challenges
Necessity, time, and signatures top list of watch points.Every detail counts when your ane... Read more
News You Can Use:
Verify Whether Your Local Rules Allow Non-supervised CRNA Work
States continue to opt out of CRNA supervision regulation.If you code for CRNA services, b... Read more
Pain Management:
Diagnosis 847.0? Follow Therapy Progression to Correct Whiplash Coding
Watch for scans, TPIs, and more as treatment options intensify.Coding for whiplash diagnos... Read more
2 New H Codes Will Replace 366.16 in 2013
Be sure to report the correct 'unspecified' option.When ICD-9 becomes ICD-10 in October 20... Read more
Reader Questions:
Crosswalk 65420 or 65426 to 00140 for Pterygium Surgery
Question: How should we code for pterygium surgery performed in a surgery center? What&#... Read more
Reader Questions:
Verify if 786.01, 300.11 Indicate Vent Study
Question: Our anesthesiologist included several diagnoses on a chart: 786.01, 300.11, and ... Read more
Reader Questions:
Get Specific With TMJ Diagnosis for Success
Question: Our provider included two diagnoses in the documentation for a temporomandibular... Read more
Reader Questions:
Time Notations Override Graph Intervals
Question: An auditor told us the doctor should put his start and stop times on the record ... Read more
Reader Questions:
Check Details to Determine Modifier for Denied Claim
Question: A commercial payer denied our claim, stating we needed to include an additional ... Read more
Reader Questions:
Submit 00400 for Skin-Sparing Mastectomy
Question: Our physician provided anesthesia during a skin-sparing right mastectomy. What... Read more
Reader Questions:
Remember Modifier 53, Case Details for Cancelled Procedure
Question: We had a patient scheduled for a colonoscopy with biopsy who experienced an epis... Read more
You Be the Coder:
20550, 97140 Hinge on Documentation Amounts
Question: The physician completed a periligamentous block to C6- C7 and C7-T1 with manual ... Read more
CPT 2011:
Don't Miss New Joint Injection Guidelines That Kick In January 1
Revised directions change ultrasound, T12-L1 reporting.Remember to check for updated or re... Read more
CCI 17.0:
Anesthesia Overrides Bronchoscopy in Newest Edits
Report anesthesia service instead of new cath or tube placement codes.The newest edition o... Read more
2011 Preparation:
Check These 4 Areas for Small -- But Important -- Claim Changes
Diagnosis, PQRI, and E-prescribing top experts' lists of watchpoints. Approximatel... Read more
Start Tracking Your Most Common Diagnoses for ICD-10 Changes
550.90 will become K40.90. ICD-10 implementation in 2013 is coming fast, so take steps... Read more
Reader Questions:
20552, 20553: Base TPI Code on Muscles
Question: My understanding is that the paraspinal muscle is a group of individual muscles ... Read more
Reader Questions:
Crosswalk to 00126 for Tympanostomy
Question: The anesthesiologist provided service during a tympanostomy of the left ear on a... Read more
Reader Questions:
Report 01922 Plus Documentation for MRI
Question: Our anesthesiologists are beginning to work with patients having MRIs in a radio... Read more
Reader Questions:
Submit 01999 for NG Tube Anesthesia
Question: The anesthesiologist performed MAC (monitored anesthesia care) during nasogastri... Read more
Reader Questions:
Multiple Physicians, But Single 01967
Question: Physician A administered an OB epidural; Physician B checked on the patient 15 m... Read more
Reader Questions:
Postop Catheter Coding Allowed When Separate
Question: Our provider used monitored anesthesia care (MAC) for the primary mode of anes... Read more
Reader Questions:
Submit 00670 for Harrington Rod Surgery
Question: What would be the best anesthesia code for spinal surgery including laminectom... Read more
Reader Questions:
Avoid a 'Finders Keepers' Overpayment Mentality
Question: We've discovered that a patient overpaid us on her copay. We collected $50, whic... Read more
Reader Questions:
Look to 64640, J7335 for Capsaicin Patch
Question: Does Medicare cover the capsaicin patch? If so, how should we code it?Answer: 20... Read more
You Be the Coder:
Correctly Count Each Nerve for 64622
Question: Can you explain how to bill 64622? Do we report the code per level or per nerve ... Read more