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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
ICD-10:
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
ICD-10:
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
Documentation:
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
ICD-10:
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
ICD-10:
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
Definition:
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
E-Prescriptions:
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
ICD-10:
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
Modifiers:
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
Definitions:
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
ICD-10:
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
ICD-10:
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
Documentation:
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
ICD-10:
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
Documentation:
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
ICD-10:
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
Clarification:
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
ICD-10:
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
ICD-10:
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