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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
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
Check Out the Future Changes for Ischemic Cardiomyopathy Coding
Today's 414.8 will soon have three more detailed options. Anesthesiologists someti... Read more
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
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
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
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
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
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
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
Focus on 4 Areas to Streamline Medicare Secondary Payments
Start with all insurance cards, not just Medicare. Anesthesia providers don't ofte... Read more
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
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
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
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
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
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
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
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
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
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
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
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
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
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