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Anesthesia Coding Alert

Cardiac Anesthesia:
Study 4 Checkpoints to Swan-Ganz Catheter Success
Tip: Knowing each line's purpose can help your chances of separate pay. Getting paid for a... Read more
News You Can Use:
Make Safety Your Focus During Fungal Meningitis Outbreak
Check out this top advice from the ASA's infection control task force. One of the top news... Read more
CCI 18.3:
Don't Miss These Edits Affecting Injections During Repair, Discography
Pain management changes are widespread, but easy.The most recent Correct Coding Initiative... Read more
Reader Question:
Count Cases to Determine Supervision Vs. Direction
Question: I know that if the anesthesiologist medically directs more than four concurrent ... Read more
Reader Question:
Intubation Overrides Vent Management Service
Question: Can we bill Medicare for intubation (31500), ventilation assist/management (94... Read more
Reader Question:
Look at E/M Codes for Ongoing Lumbar Drain Check
Question: The physician inserted a lumbar drain and wants to leave it in place for several... Read more
Reader Question:
Payer Preference Helps Guide Correct 80101 Reporting
Question: Our pain management physicians perform random drug screenings, and I have a ques... Read more
Reader Question:
ICD-9 Freeze Will Spare You New Updates This Year
Question: Are there any ICD-9-CM updates planned for 2013? Iowa Subscriber Answer: No ICD-... Read more
Reader Question:
Submit All Drug Details on Claim Form
Question: We provide injections and infusions in our office and seem to keep getting denia... Read more
You Be the Coder:
Knowing 'Upper' Versus 'Lower' for Colectomy Anesthesia
Question: Where would the incision be made for a procedure to be considered "upper" when I... Read more
CPT® 2013:
Watch for These Tweaks to Anesthesia Codes for Prone Position
Plus: Don't miss chemodenervation changes for your pain management specialist. Your top 20... Read more
CCI:
Be Careful of Coding Line Placements With Wound Repair, Thanks to New Edits
CCI 18.3 also classifies epidural patches above repairs.The most recent edition of Correct... Read more
ICD-10:
Check Out the Future Changes for Ischemic Cardiomyopathy Coding
Today's 414.8 will soon have three more detailed options. Anesthesiologists someti... Read more
Compliance:
Get the Scoop on HIPAA Audits That Could Be Heading Your Way
Start working now to ensure your privacy and security practices are on par.Every anesthesi... Read more
Reader Question:
Review Contracts for Details on MD/CRNA Case Reimbursement
Question: How do insurers reimburse for out-of-network claims when the case involves both ... Read more
Reader Question:
Documentation Guides Whether You Can Report L&D Epidural Removal Time
Question: What amount of time should we include on the claim for epidural removal followin... Read more
Reader Question:
First Failed Moderate Sedation Should Be 995.24
Question: Sometimes our anesthesiologist is asked to provide MAC (monitored anesthesia car... Read more
Reader Question:
Base 64421 on Regions, Not Individual Injections
Question: Our physician administered blocks to the T8, T9, T10, and T11 areas. He believes... Read more
You Be the Coder:
Supporting Anesthesia Without Modifier 23k
Question: How do we report the anesthesia service when the CPT® code is classified a... Read more
Catheter Placement:
5 Questions Guide You to the Correct CVA Choice Every Time
Watch patient age, procedure description when identifying venous access devices.CPT®... Read more
Bonus Tip:
Beware 'Brand Names' When Coding CVAs
Making assumptions can point you to the wrong code. Physicians typically tunnel some brand... Read more
ICD-10:
Turn to K65.1 to Report Peritoneal Abscess, Not 567.22
Only the code will change under ICD-10, not the descriptor. If your anesthesiologist parti... Read more
Auditing:
Is CMS Introducing Pre-Pay Audits in Your State?
Check whether your practice might come under extra scrutiny.Here's your latest heads up fo... Read more
Reader Question:
Hospital Follow-Up Doesn't Always Point to 99232
Question: The anesthesiologist placed an indwelling thoracic epidural catheter at T6-T7 fo... Read more
Reader Question:
BP Monitoring, Pulse Ox Included in Anesthesia Service
Question: Can we bill for blood pressure monitoring, pulse oximetry, and running a rhythm ... Read more
Reader Question:
Extent of Care Guides 00400 or 01810 Choice
Question: The anesthesiologist started an IV and administered a digital block for a finger... Read more
Reader Question:
Hold Off on ICD-10 Codes Until 2014
Question: We are getting ready to start billing with the ICD-10 codes but have heard pract... Read more
Reader Question:
If You Can't Report 64483, Then Skip +64484 As Well
Question: Our physician performed two levels of lumbar laminectomy on a Medicare patient. ... Read more
Reader Question:
Verify Whether NP Has Billing Rights
Question: Is a nurse practitioner allowed to render service to a patient for CPT®'s ... Read more
You Be the Coder:
The Correct Code for Lumbar Drain Check
Question: Our anesthesiologist placed a lumbar drain that was left intact for several days... Read more
CCI 18. 2 Edits Not So Fast:
Double Check Codes Before Reporting Injections With Fluoro
Latest edits specify more injection procedures include guidance. ACA Vol 14 N 9 Jul... Read more
CCI 18. 2 Edits:
Not So Fast: Double Check Codes Before Reporting Injections With Fluoro
Latest edits specify more injection procedures include guidance. The latest Correct Coding... Read more
News You Can Use:
Supreme Court Upholds ACA Legality -- What Does It Mean for Anesthesiologists?
Get insider opinions from some experts in your field.What does the latest news regarding t... Read more
ICD-10:
Bleed Location Directs Your Hemorrhage Coding In ICD-10
Prepare now for 50+ new codes associated with 998.11.When your anesthesiologist participat... Read more
Billing:
3 Quick Tips Keep Your Medicare Secondary Payer Claims Clean
Hint: Be sure you have all insurer info, not just Medicare. When your practice perform... Read more
Reader Question:
Take Care Before Reporting G8553 for RN Transmission
Question: One of our providers orders the patients' prescriptions, but the nurse (who is e... Read more
Reader Question:
Base Split-Time Coding on Provider With Most Time
Question: A recent surgical case involved two of our anesthesiologists: one for two hours ... Read more
Reader Question:
Report Exact Anesthesia Minutes, Not Rounded Time Units
Question: Our anesthesia practice is out of network with many insurance companies. We don'... Read more
Reader Question:
Dig Into Details Before Filing 01996 With Epidural
Question: If our anesthesiologist places an epidural catheter for a patient's labor, we on... Read more
Reader Question:
Skip Fluoro for T12-L1 Facet Injection
Question: The physician advanced a 25 gauge spinal needle into the posterior aspect of the... Read more
Reader Question:
Choose J3490 -- Not J2001 -- for SI Lidocaine Injection
Question: Our physician administered a sacroiliac steroid injection using 1cc of 1 percent... Read more
Reader Question:
Don't Be Surprised at MAC 'Look Back' Beyond a Year
Question: How far back can payers go when requesting medical records for review? Oklahoma ... Read more
Reader Question:
Select 01992 for Anesthesia During TEE
Question: Our physician provided anesthesia during a transesophageal echocardiography... Read more
Reader Question:
Turn to 00537 for Hybrid Maze
Question: What is a hybrid maze procedure? How should we code anesthesia for it?Florida Su... Read more
You Be the Coder:
Bronchial Blocker Coding Explained
Question: Can you explain what a bronchial blocker is and how we code for it?Delaware Subs... Read more
MAC Anesthesia:
Double Check Documentation Before Submitting QS or Other MAC Modifiers
Payer policies dictate when MAC modifiers apply. Even if your anesthesia provider marks "M... Read more
Abdominal Coding:
Choosing Between 00790 and 00840? Documentation Moves You in the Right Direction.
Hint: Don't assume it's the point of incision. Anytime you code for anesthesi... Read more
Clip and Save:
Handy Chart Helps Pinpoint Correct Abdominal Quadrants
Don't miss ASA division between upper and lower abdomen. If you have trouble deciding whic... Read more
ICD-10:
Breast Neoplasms Will Shift from 174-175 to C50
Male and female breast diagnoses will be combined into one family.You currently have a fai... Read more
News Flash:
Will Your CRNAs Be Able to Practice Without MD Supervision?
California's State Supreme Court passes on reviewing previous decisions. The ques... Read more
Reader Question:
Code 36569 Normally Applies to Power Wand Usage
Question: Our anesthesiologist is investigating using the power wand. What exactly is it f... Read more
Reader Question:
Payer Dictates Propofol With Endoscopic Procedures
Question: Is Propofol separately reimbursable with endoscopic procedures, or is it bundled... Read more
Reader Question:
Report 99360 for Stand-By Time -- Except for Medicare
Question: A surgeon has requested that our anesthesiologist be on stand-by for a procedure... Read more
Reader Question:
Sedatives Aren't Required for MAC
Question: My understanding is that as long as the anesthesiologist does everything else in... Read more
Reader Question:
Opt for 20552 for Piriformis Injection Over 64445
Question: A co-worker and I disagree over the correct code for a piriformis injection. I t... Read more
You Be the Coder:
Is Coding 00520 With Nerve Block Legitimate?
Question: I received a charge ticket for bronchoscopy and upper endoscopic biopsies becaus... Read more
Look at Discography Levels to Correctly Report 72285 and 72295
Subscriber Question: The descriptors for codes CPT 62290 and CPT 62291 specify "each lev... Read more
MAC Coding:
Learn Definitions and Focus on Airway to Separate MAC From Moderate Sedation
Plus: Remember it's a type of anesthesia, not just sedation level. Monitored anes... Read more
Documentation:
Drill Down in Surgery Reports to Find Hidden Gems for Anesthesia Claims
Hint: Pay special attention to throacoscopy, spine, and cardiac cases. Anesthesia coders a... Read more
Billing:
Focus on 4 Areas to Streamline Medicare Secondary Payments
Start with all insurance cards, not just Medicare. Anesthesia providers don't ofte... Read more
ICD-10:
669.7x Cesarean Delivery Options Switch to a Single Code in ICD-10
Heads up: Be sure to include an outcome code.Currently, you document a cesarean delivery b... Read more
Reader Question:
Open Versus Closed Revascularization Difference
Question: Revascularization procedures for codes 37220-37234 can be performed as either op... Read more
Reader Question:
Separate 64417 and 01810 Depends on Documented Purpose
Question: How would you code this case that included discontinuous time?  Provider: A... Read more
Reader Question:
Keep These Tips In Mind for +99140 Submission
Question: Our biller wants to report+ 99140 for the anesthesiologist's professional compon... Read more
Reader Question:
Patient Position Dictates 01991 or 01992 for SI Anesthesia
Question: Which is the best anesthesia code for an SI joint injection? Vermont SubscriberA... Read more
Reader Question:
Turn To Level, Not Session for 72285 and 72295
Question: The descriptors for codes 62290 and 62291 specify "each level." Should we report... Read more
You Be the Coder:
Shifting Between MD Supervision and Direction
Question: Four CRNAs from our group were working on separate cases under the anesthesiolog... Read more
Documentation Strategies:
Clue In to Medical Direction, Physical Status for Improved Claims Results
Add these 4 items to your ‘don’t miss’ list when checking procedure no... Read more
Reimbursement:
Billing Locum Tenens? Get Answers to Your Top 3 Questions.
Remember Q6 belongs with physicians, not CRNAs. One of your anesthesiologists schedule... Read more
ICD-9/ICD-10 Update:
Know Your Regions to Determine Best Radiculopathy Diagnosis
Plus: Prepare now for expanded diagnosis choices under ICD-10. Your physician's notes docu... Read more
Reader Question:
Type of Guidance Determines 64483 or 0230T
Question: We submitted 64483 and 99144 for procedures during the same patient encounter, b... Read more
Reader Question:
G8644 Applies For 'No License' Exceptions
Question: Is G8644 used when a provider doesn't have authority under federal law to write ... Read more
Reader Question:
Double 76942 OK for Second Provider
Question: Two providers from the same physician group performed two separate postoperative... Read more
Reader Question:
Know CRNA Choices for Colonoscopy
Question: Is a certified registered nurse anesthetist (CRNA) allowed to bill Medicare fo... Read more
Reader Question:
35860 Crosses to 01770
Question: A patient had a right groin AV graft inserted for end stage renal disease. He re... Read more
Reader Question:
Confirm Procedure Before Coding Blood Patch
Question: How do I code an epidural blood patch procedure on the same day as labor and del... Read more
Reader Question:
62311 With 01992 Depends on Providers
Question: Can I bill 01992 for anesthesia for 62311?California SubscriberAnswer: It depend... Read more
Reader Question:
Moyamoya Procedure Calls for Unlisted Procedure Code
Question: What is the correct code for a procedure called an "encephaloduroarteriosynangio... Read more
You Be the Coder:
Pain Killing Agents and Plantar Injections
Question: Our physician administers a lot of steroid injections and injections of anesthet... Read more
Documentation:
4 Vital Items You Don't Want to Miss In the Anesthesia Record
Extra units for reimbursement might be lurking in places other than the charge ticket. Ane... Read more
Reimbursement:
Don't Miss This Increase in the Medicare ACF for All 2012 Claims
Re-analyze your claims for Q1 services that deserve higher pay.You have reason to celebrat... Read more
Injection Coding:
Check These Injection and Bilateral Red Flags Before RACS Catch Up
Plus: Contractors are also auditing place of service, bilateral services, and consolidated... Read more
ICD-10:
Watch for Presence of Heart Failure Under New I11.- Codes
ICD-10 eliminates malignant/benign dilemma for hypertensive heart disease.When coding for ... Read more
Reader Question:
Check Local Policies to Guide Pain Score Documentation
Question: I am having a debate with my physician regarding what he needs to document in hi... Read more
Reader Question:
Modifier AD Applies to Maxed Concurrent Cases
Question: What are the current Medicare rules when our anesthesiologist bills more than fo... Read more
Reader Question:
Verify Surgical Approach for Stress Incontinence Sling
Question: Our physician provided anesthesia during surgery to place a stress incontinence ... Read more
Reader Question:
Reason for OR Return Dictates Modifier Choice
Question: A patient returned to the operating room (OR) later the same day of surgery beca... Read more
Reader Question:
Choose 00142 for Cataract Block, Not 01991
Question: I have a CRNA who practices solo at a surgery center doing cataract anesthesia... Read more
Reader Question:
Rely on 20610 for Ischial Tuberosity Bursa Injection
Question: What CPT code can I use for an ischial tuberosity bursa injection? Wisconsin... Read more
You Be the Coder:
Correct Cross Code for Nerve Block 64483
Question: We have an ongoing debate in our office about the correct anesthesia code to rep... Read more
Documentation:
Ask These 3 Questions Before Coding Post-Op Pain Management
Post-op add-on success hinges on documenting separate service. When your anesthesiologist ... Read more
Line Placement:
Earn Almost $100 for PICC Line Insertion -- If the Right Person Provides the Service
Check 3 factors to ensure your billing is correct. Anesthesia providers often place lines ... Read more
CVC and CVA Lines:
Here's How to Distinguish
Hint: Insertion, depth help you decide.Anesthesia providers use a variety of lines to acce... Read more
Collections:
Bottom Line Woes? See Improvement With 12 Easy-to-Implement Strategies
Plus: You'll help meet your patients' changing payment needs, too.Because every dollar cou... Read more
ICD-10:
Prepare Now for Multiple Diagnosis Choices for Secondary Parkinsonism
ICD-10 will expand options for more specificity.Anesthesia providers sometimes rely on und... Read more
Reader Question:
Classify Posterior Shoulder With Trunk, Not Extremity
Question: Our physician provided anesthesia while the surgeon removed a lipoma on the pati... Read more
Reader Question:
Angioplasty Code 37226 Crosses to 01924
Question: The surgeon performed an arteriotomy in the femoral artery to remove an aneurysm... Read more
Reader Question:
Observation Codes 99218-99220 Could Apply to OR Watch
Question: A patient came to the OR for an extubation and observation, just in case he need... Read more
Reader Question:
00300 Applies to Exploration of Neck Hematoma
Question: A patient underwent a thyroidectomy in the morning. She was brought back to the ... Read more
Reader Question:
Deciding Between 00630 and 00670 Hinges on Instrumentation
Question: The CRNA provided anesthesia during direct lateral interbody fusion with postero... Read more
Reader Question:
Learn Expiration Time Frame for Billing Patients
Question: Is there a time limit on when you can bill a patient for their balance due after... Read more
You Be the Coder:
Choose Correctly for TAP Catheter Insertion
Question: What is a TAP catheter, and what's the correct code for insertion? West ... Read more
CCI Update:
2012 Guideline Addition Clarifies When Post-Op Pain Management Is Acceptable
Tip: Remember modifier 59 is your friend. You've been busy applying new and revis... Read more
Avoid These Hot Spots When Coding Burn Care
Hint: Anesthesia coders follow the same tactic as surgical coders. Coding for burns t... Read more
Clip and Save:
Follow This Tool to the Best Modifier for Same-Day Services
A few simple questions help point you in the right direction. If your practice keeps getti... Read more
ICD-10:
Prepare Now to Separate 'Burns' from 'Corrosions'
ICD-10 will keep additional TBSA code.Coding burns based on body site and "degree" plus an... Read more
Reader Question:
Choose 01992 or 01992 for Second MD's Anesthesia During Block
Question: We've had several charges lately for epidural injections under anesthesia. The p... Read more
Reader Question:
Select Separate Codes for Separate Puncture, Chemo Admin
Question: Our anesthesiologist worked with the oncologist on a case involving a lumbar pun... Read more
Reader Question:
Follow Month, Not Year, for 'Birthday Rule'
Question: I just received a call from a patient's parent claiming that we didn't follow th... Read more
Reader Question:
Choose 36556 for Subclavian Vein Catheter
Question: One of our physicians is asking about the correct code for placement of a centra... Read more
Reader Question:
Check Date of Service Before Filing 27096 With Fluoro
Question: Some of our payers deny 77003 when we bill it with SI joint injections during th... Read more
You Be the Coder:
Modifier 78 Might Not Be Best for OR Return
Question: We have a two-surgery claim for a patient, with the payer denying the second p... Read more
CCI 18.0 Edits Update:
Latest CCI Edits Nix Anesthesia With New Neurostim Array Codes
TPI and tendon injections override 100+ other procedures. Now that 2012 is here, it&#... Read more
Modifiers:
Use This 4 Step Plan to Justify Reporting Modifier 23
Tip: Watch for patient-specific details to support unusual circumstances.If your anesthesi... Read more
Compliance:
Let These 3 FAQs Guide Your ICD-10 Implementation Efforts
Part of your 2012 plan should include focusing on your most common codes.Despite recent ru... Read more
ICD-10:
Prepare for 'Greater Detail' Pneumothorax Codes in 2013
But first, fifth-digit requirements on NOS go into effect next year. When a patient ex... Read more
Reader Question:
Look to Payer Policy For 01967/+01968 Claim
Question: The anesthesiologist started an epidural for a Medicaid patient on Nov. 3, then ... Read more
Reader Question:
Codes 62310-62319 Apply to Intrathecal Injection
Question: The anesthesiologist administered an intrathecal injection prior to a patient's ... Read more
Reader Question:
Compare Charts to Decide on 76 or 78 for Second Surgery
Question: A patient had a CABG procedure, then had to return to surgery later the same day... Read more
Reader Question:
Payer Determines Whether Basic Anesthesia Covers TEE
Question: Is transesophageal echocardiography included in basic anesthesia administration ... Read more
Reader Question:
Start With 29825 When Coding for 'Frozen Shoulder'
Question: Our anesthesiologist participated in a procedure for the arthroscopic release of... Read more
Reader Question:
Opt For Higher Base, Not Multiple Codes
Question: Should I include any modifiers when submitting claims for a double procedure, su... Read more
Reader Question:
Start With RVU Order for Better Billing
Question: I know that as a general rule the highest RVU has a higher billed amount and tha... Read more
Reader Question:
Don't Get Too Comfortable With 5010 Grace Period
Question: I saw that CMS moved the 5010 implementation deadline to March 31 -- which ... Read more
You Be the Coder:
Narrow Choices for Lumbar Cath Placement With Follow-Up
Question: Our anesthesiologist placed a lumbar plexus catheter for anesthetic, and made ... Read more
Claims Submission:
Start Calculating Minutes -- Not Units -- to Prevent Payment Delays
5010 standards lead to universal time reporting rules effective Jan. 1. While all physicia... Read more
Diagnosis Coding:
V Codes Might Hold the Answers to Tricky Anesthesia Situations
Don't shy from submitting the same V code as surgeons.If you avoid the V code section of I... Read more
Fee Schedule:
Prepare for 26.2 Percent ACF Cut in 2012, if Congress Doesn't Step In
Plus: National Medicare CF could drop 27 percent.Get ready to end another year wondering h... Read more
ICD-10:
455 to I84 Diagnosis Shift Means 2 More Digits
Tip: Look for complication first before coding in 2013.You'll need to compare your anesthe... Read more
ICD-10 News:
CMS Clarifies How to Report Services That Span ICD-10 Implementation Date
As practices prepare for ICD-10 implementation on Oct. 1, 2013, one practical question k... Read more
Correction:
Double Check New Gastric Band, Respiratory Failure ICD-9 Codes
New 539 family offers more choices.Several surgical additions to diagnoses in ICD-9 2012 c... Read more
Reader Question:
Use 01968 for Complete C-Section, Not Partial Help
Question: When an anesthesiologist starts a labor epidural for a vaginal delivery and then... Read more
Reader Question:
Opt for 01961 for C-Section, Nothing for Injection
Question: Our anesthesiologist administered spinal anesthesia for a cesarean section and a... Read more
Reader Question:
'SMP' Note Means 'RSD'
Question: Which diagnosis applies to sympathetically maintained pain? Is it the same as re... Read more
Reader Question:
00400 Usually Applies to Groshong Removal
Question: What is the correct code for removal of a Groshong catheter? New Jersey Subscrib... Read more
Reader Question:
Calculate Amount for Correct Kenalog Injection Choice
Question: How should I report an intra-epididymal injection of Kenalog?South Carolina Subs... Read more
Reader Question:
Marcaine Before Injection? Don't Count on Payment
Question: We've had increasing problems billing and being paid for the medications we use ... Read more
Reader Question:
List As Many PQRS Codes As Needed
Question: Can we report more than one PQRS code measure on the same claim?Answer: Yes. You... Read more
Reader Question:
Avoid Separate Coding for Bier Block
Question: Our physician used a Bier block during treatment of CRPS-upper extremity. Is the... Read more
Reader Question:
Make Up for Lost Time With 5010 Implementation
Question: We're behind schedule with our HIPAA 5010 implementation and are not sure that w... Read more
You Be the Coder:
Choosing Between Modifier QS and Moderate Sedation
Question: Would you explain the difference between MAC (monitored anesthesia care) and IV ... Read more