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Anesthesia Coding Alert

Your Payment for Epidural Injection Codes Could Change in 2015
CMS proposes updates to several anesthesia or pain management services.  New fee ... Read more
ICD-10 Transition:
Here Are Your 2 Key Focus Areas as You Transition to ICD-10
It’s never too early – or late – to start preparing. With ICD-10 imp... Read more
ICD-10 Training:
FBR With Puncture Wound Will Focus on Affected Eye
New diagnoses won’t be built around whether metal is present.  Your anesthe... Read more
Put These 3 HIPAA Lessons to Work for Your Practice
Learn from others’ mistakes and keep your practice in the clear.  Focusing ... Read more
Reader Question:
Count Muscles Before Selecting 20552 or 20553
Question: Could you please explain the difference of 20552 and 20553 and include an... Read more
Reader Question:
Combine and Bill Under One Physician for Labor Epidual
Question: We have a labor epidural that has two start and stop times by two anesthe... Read more
Reader Question:
Submit 01630 for Humeral Shaft Hardware Removal
Question: What anesthesia code would you recommend for removal of hardware from the... Read more
Reader Question:
Don't Forget How to Correctly Count Radiofrequency Ablations
Question: We used to bill radiofrequency ablation codes 64633, 64634, 64635, and 64... Read more
Reader Question:
Know Injection Site to Separate 77002 From 77003
Question: What is the difference between fluoro codes 77002 and 77003? Is the diffe... Read more
You Be the Coder:
Know When 96372 Bundles With 62310 or 62311
Question: A patient visited our office for therapeutic injections of Toradol and Ke... Read more
CPT® 2015:
Prepare Now for Changes to TAP Block and TEE Monitoring Codes
2015 will bring several new options specific to anesthesia providers.  If you reg... Read more
Anesthesia Modifiers:
Master the Art of Using the Correct Performance and Patient Status Modifiers
Modifiers do not ensure reimbursement.  One aspect of anesthesia coding that sets... Read more
Don't Shy From Asking for Surgeon's Notes When 938 Shifts to T18.9
You’ll need more details for foreign body removal under ICD-10. It’s not u... Read more
Reader Question:
Code Venipuncture with CPT® 36400 and 36410
Question: How do I code for venipuncture when anesthesiologist is called to perform a... Read more
Reader Question:
Check When Hypothermia Is Inherent
Question: When is it not correct to append +99116 for hypothermia? Florida Subscr... Read more
Reader Question:
Know How to Handle Single Person PHI Breach
Question: What must we do in terms of breach notification if we mail a statement to... Read more
Reader Question:
Include Modifier GC on Teaching Physician Claims
Question: When a resident assists a physician in a teaching hospital, do we need to... Read more
You Be the Coder:
How to Keep Track of the Start and End Times
Question: When does anesthesia time start and stop? Virginia Subscriber  ... Read more
CPT 2015:
Here's Your Sneak Peek at Code Changes for 2015
Don’t miss how joint injections and TAP blocks will be reported. Whether you cod... Read more
Post-op Management:
Remember These 4 Points Before Reporting Post-op Pain Management
Documentation of your provider’s role is crucial. Surgeons normally provide post... Read more
Know Where to Find AICD Codes Even if That's Not the Reason for Surgery
Section for codes will change in 2015, but descriptors won’t vary much.  Ce... Read more
Reader Question:
Report 99144 for Same-Physician Sedation and Procedure
Question: A 34-year-old patient with a dislocated left shoulder reported to the out... Read more
Reader Question:
Code Controlled Hypotension With +99135
Question: There’s some confusion in our office regarding coding for controlle... Read more
Reader Question:
Rely on Anesthesia Report, Not Charge Ticket, for Nerve Block
Question: The charge ticket reported bronchoscopy and upper endoscopic biopsies bec... Read more
Reader Question:
Remember That Nerve Block Includes Nerve Stimulation
Question: Our provider used both ultrasound guidance and electrical stimulation for... Read more
Reader Question:
Focus on Length of Catheter When Choosing Between 62311 and 62319
Question: I need some guidance on the differences between 62311 and 62319. Both cod... Read more
Reader Question:
Here's How to Handle Potential Timely Filing Problem
Question: Our physician saw a patient who didn’t have her insurance informati... Read more
You Be the Coder:
Understand the Situation When Using J3490 and +99100
Question: In our hospital we use CRNAs in our ambulatory surgery center to provide ... Read more
Medical Direction:
Know How to Include Those Extra Emergency Services in Your Claim
Figure out what qualifies as “emergency.”  “Emergency of short ... Read more
Modifier 25:
Find Modifier 25 Claims Success by Focusing on This 'Do' and 'Don't'
Remember: E/M plus service doesn’t always equal 25.  If your anesthesia pro... Read more
Get Your Answers Ready for 6 Common Complaints About ICD-10
Expert tips help you turn issues into positives.  With ICD-10 scheduled to become... Read more
Reader Question:
Check the Minutes for Moderate Sedation
Question: In an emergency setting moderate sedations are usually less than 16 minut... Read more
Reader Question:
Report Subsequent Care Codes to Cover Pre-Anesthesia Exam
Question: An anesthesiologist at our facility spent about 20 minutes on the pre-ane... Read more
Reader Question:
Append Modifier 78 for Unplanned Return to OR
Question: Mr. Brown had endoscopic sinus surgery and then had to return to the oper... Read more
Reader Question:
Keep the Setting in Mind While Coding For POS 49
Question: Our office was coding CPT® codes 64635, 64636, and the J code with th... Read more
You Be the Coder:
How to Tackle a CRNA's Preoperative Service
Question: What is the appropriate code for a CRNA doing pre-admission testing in an... Read more
Medical Direction:
Work With Your Carrier to Define 'Short Duration' and Meet Criteria
Know whether extra services help or hurt your claim  Your anesthesiologist is med... Read more
Check Surgeon's Record for Necessary Details About Acute on Chronic Respiratory Failure
Plus: Watch whether the patient’s condition merits a higher P status modifier.&nbs... Read more
Proposed CMS Rule Could Relieve Your 'Meaningful Use' Deadline Stress
Deadline extensions and three compliance options make implementation more doable. If y... Read more
Reader Question:
63707 or 63709 Best Options for Gelfoam Epidural Repair
Question: Our provider blocked a lumbar dural tear with a single piece of gelfoam. ... Read more
Reader Question:
Focus on Anesthesia Codes When Not Administering Injection
Question:  If a facet block is done under MAC (monitored anesthesia care) anesthesi... Read more
Reader Question:
Documentation Guides Whether 64448 and 99231 Are Allowed Together
Question: The anesthesiologist re-administered a patient’s postoperative pain... Read more
Reader Question:
Remember Modifier 59 for 62311/77003 Claim
Question: We normally bill 62311, 77003, and a J code for epidural injections. A re... Read more
Reader Question:
Harrington Rod Surgery Leads to 00670
Question: The anesthesiologist personally provided anesthesia service for a patient... Read more
Reader Question:
Report Pulse Generator Removal Over Debridement
Question: Our pain management provider removed two leads and a pulse generator due ... Read more
You Be the Coder:
Know the Difference Between TAP Catheter and Block
Question: What is a TAP catheter, and what’s the correct code for it? Missi... Read more
Reimbursement Focus:
Don't Miss Your Chance at Extra Units for Field Avoidance
Good news: Even if Medicare won’t pay, other payers often do.  Seeing a not... Read more
Watch for Expanded Cardiomyopathy Diagnosis Choices
Plus: Don’t forget to check if anesthesia modifiers apply to the case.  ICD... Read more
Office Management:
Let These 6 Questions Test Your Contingency Plan Know-How
Understand what is truly critical to your office operations. Whether you’re pote... Read more
Reader Question:
Focus on Reason for Procedure When Choosing a Diagnosis
Question: Should the ICD-9 placed on the 1500 claim form be related to the procedur... Read more
Reader Question:
Report 01961 for Tubal Ligation During C-Section
Question: What is the correct way to bill the anesthesiologist’s time when th... Read more
Reader Question:
Choose 01120 Over 00630 for Sacral Ulcer Debridement
Question: We have raised a question in our office regarding a debridement of a sacr... Read more
Reader Question:
Double Check Documentation Before Considering OB Consult Coding
Question: I have a couple of anesthesiologists that perform OB consults for patient... Read more
You Be the Coder:
Choosing Anesthesia for Spinal Hardware Insertion
Question: The Anesthesiologist personally provided anesthesia service for a patient... Read more
3 Tips Help You Ethically Handle Incomplete Medical Direction
Look before you leap into using these tricky modifiers Anesthesia coders know that a p... Read more
Watch for Fewer Choices for Essential Hypertension Coding
Also: Watch for notes about associated organ involvement. AHypertension can increase t... Read more
Remember the Rules for Medical Direction
Meet these 7 criteria and you’re on your way to –QY or –QZ success.&nb... Read more
Learn Big Lessons From Florida Security Breach Case
Follow these 6 steps to ensure it doesn’t happen to your practice.  A recen... Read more
Reader Question:
Place of Service Guides Ultrasound Coding for Epidural Placement
Question: Is it feasible to use ultrasound rather than fluoroscopy for guidance whe... Read more
Reader Question:
Don't Miss New Crosswalk Options for 27759
Question: In the 2013 ASA Crosswalk, CPT® 27759 crossed to anesthesia code 0148... Read more
Reader Question:
Shoulder Arthroscopy Crosses to 01630
Question: Some of our coders report 01630 for anesthesia associated with 29827 and 29... Read more
Reader Question:
CABG Switches to Cystoscopy
Question: Our anesthesiologist went in to do a CABG case that began at 7:10 a.m. Th... Read more
Reader Question:
62272 Could Be Best for Lumbar Drain Placement
Question: Our pain management specialist placed a lumbar drain and this was left in... Read more
Reader Question:
Congenital Vs. Acquired Could Help With Lumbar Pars Defect Diagnosis
Question: I reported 64493 for a lumbar pars injection. The associated diagnosis is... Read more
You Be the Coder:
Choosing Your Code for AAA Endograft Repair
Question: The surgeon used an endograft to repair an abdominal aortic aneurysm (AAA... Read more
ICD-10 Implementation Delay Means More Time for Your Practice to Prepare
Also: Fee schedules stay the same, but physicians seek a permanent SGR formula revision.... Read more
CCI 20.1:
Watch Which Chemodenervation Code Overrides Others When Paired Together
Latest coding edits bring 64615, 64616 to the forefront.   If you code for chemod... Read more
Follow These 7 Criteria to Ensure Compliant Records Every Time
Hint: Thorough encounter notes are your key to success. Much of your coding depends on... Read more
Reader Question:
Know Payment Indicator to Determine ASC Status
Question: If an ASC supplies the drugs used by an anesthesiologist, can it bill for... Read more
Reader Question:
Biopsy/Ligation 37609 Crosses to 00352
Question: Our anesthesiologist provided MAC anesthesia for a patient’s surger... Read more
Reader Question:
Learn Up Front Whether Payer Accepts P Modifiers
Question: We’re having reimbursement issues with one of our private insurers ... Read more
Reader Question:
Closed Fundoplication Points to 00740
Question: The surgeon completed a transoral incisionless fundoplication for GERD. S... Read more
Reader Question:
Know Which Trigeminal Nerves Are Injected Before Coding
Question: Our pain management specialist documented “0.5 ML across the right ... Read more
You Be the Coder:
Stop Time for L&D Epidural
Question: We’re having trouble agreeing on the correct stop time for an epidu... Read more
Qualifying Circumstances:
Remember 3 Foundational Points Before Adding +99100 to Your Claim
Hint: Even though Medicare won’t pay, don’t write off all other payers. ... Read more
Procedure Coding:
Take 3 Easy Steps to Reach Paravertebral Facet Joint Coding Success
Hint: Think in terms of joints, not nerves.  If your physician administers parave... Read more
Don't Shy From Contacting Surgeon's Office to Get Specific Umbilical Hernia Diagnosis Details
Tip: You’ll still need to watch for the presence or absence of gangrene. When yo... Read more
Reader Question:
Verify Time Unit Measurements With Payers
Question:  I’m new to anesthesia billing and have a question about calculatin... Read more
Reader Question:
Look Ahead to When Windows XP Won't Be HIPAA Compliant
Question:  Our IT guru said we won’t be able to use Windows XP computers any ... Read more
Reader Question:
Check Whether You Can Avoid the 64642 and 64615 Denial
Question:  I have a patient who suffers from migraines and receives treatment with ... Read more
Reader Question:
Start With Payer Policies to Answer Multi-Provider L&D Questions
Question: I’d like some input for proper coding of anesthesia related to labo... Read more
Reader Question:
MAC Could Be Billed Without Sedative Administration - Maybe
Question: How should we code for monitored anesthesia care (MAC) without sedation b... Read more
You Be the Coder:
Modifier QZ With Physician Supervision
Question: I code for an ASC that employs CRNAs. The ASC is in New York, which requi... Read more
CCI 20.0:
2014 Begins With More Services Bundled Into Anesthesia Codes
Latest coding edits pair thousands of procedures with common anesthesia procedures.... Read more
Brush Up on Medical Direction/Supervision Assignment With 3 Scenarios
Appending modifier AD will make a big difference to your bottom line. Knowing whether ... Read more
Meet All 7 Criteria Before Claiming Medical Direction
Plus: Know when exceptions might apply. Before appending modifiers QY (Medical directi... Read more
Plantar Fasciitis Will Have Simple Diagnosis Switch in October
Change the code, keep the descriptor. With warmer weather just around the corner, the ... Read more
Reader Question:
Submit 00790 for Cholecystectomy, Even When Partial
Question: A patient was scheduled for an open cholecystectomy. He was found to have seve... Read more
Reader Question:
Infraumbilical Exploration Points to 00840
Question: The surgeon made an incision down to the fascia where he had previously repair... Read more
Reader Question:
Eye Your Options for Retrobulbar Block Coding
Question: Our anesthesiologists sometimes administer a retrobulbar block for cataract an... Read more
Reader Question:
Remember Central Line Is Part of Swan-Ganz Placement
Question: Our anesthesiologist recently checked central line, arterial line, and Swan-Ga... Read more
Reader Question:
Choose Pump Refill Codes 62369 or 62370 Over Old 95991, 62368 Codes
Question: We used to bill the 62368, 95991, and the appropriate J code for pump refills.... Read more
Reader Question:
Separate Provider Claims Can Solve 64493/01992 Denial
Question: Our pain management physician administered an injection (64493) and the CRNA p... Read more
You Be the Coder:
Coding for Anesthesia During TEE
Question: We used to submit anesthesia code 00740 for our services associated with 93312... Read more
3 Pitfalls That Could Sink Your EHR Accuracy This Year
‘Cut and paste’ can be easy, but costly. Many specialties run into snags w... Read more
AMA Symposium:
4 Top Tips for Following New Chemodenervation Guidelines for 2014
Hint: Count muscles correctly and you’ll be on the right track. If your anesthes... Read more
Test Yourself:
Ensure You Know Recent Regulations Before Getting Too Far Into 2014
These 3 Q&As will get you on the right track. The New Year is under way, but it&rs... Read more
Pinpointing Rupture Will Be Key to AAA Anesthesia Coding Under ICD-10
Tip: Look to other code families for thoracic aneurysm. When your physician provides a... Read more
Reader Question:
Ask Payer if Modifier 22 Works for Over-the-Cap L&D Cases
Question: One of our private insurers previously processed claims for labor epidura... Read more
Reader Question:
List Medical Direction Modifier Before Q6 for Locum Tenens
Question: We have a locum tenens physician providing medical direction for a few CRNAs w... Read more
Reader Question:
Pass the Halfway Mark Before Billing Another Unit
Question: I understand that anesthesia minutes are calculated by 15-minute increments. D... Read more
Reader Question:
Watch Circumstances Before Reporting 99144 With Epidural Injections
Question: One of our physicians adds 99144 to his billing sheet whenever he performs LES... Read more
You Be the Coder:
Physician-Performed Shoulder Hydrodistention
Question: Our physician performs shoulder hydrodistention to treat adhesive capsulitis b... Read more
CPT® 2014:
Get Clear on CPT®'s Definition of 'Qualified Health Care Professional'
Plus: Check out the errata related to chemodenervation procedures. CPT® 2014 has ... Read more
Prepare Now to Request Better Documentation of Pacemaker Complications
Upcoming T82 codes will be more detailed than current diagnoses. If your provider is ... Read more
Practice Management:
Answer These 4 Questions When Deciding on Pre-Employment Drug Screening
Random post-employment screening is another option. The debate over whether drug scre... Read more
Reader Question:
Save 01996 for Daily Epidural Management
Question: Other coders in our department are using 01996 only for epidurals. If the anes... Read more
Reader Question:
Halfway Point Means Rolling to Next Time Unit
Question: I’m trying to figure out when to “round up” units when the a... Read more
Reader Question:
Special Positions and Field Avoidance Explained
Question: A patient had shoulder surgery that was performed in the beach chair position.... Read more
Reader Question:
Skip Standby Time With Medicare Patients
Question: A surgeon has requested that our anesthesiologist be on stand-by for a procedu... Read more
Reader Question:
Pain Management Injection Doesn't Always Include Other Service
Question:  A patient who was treated for a closed pelvic ring/pubic ramus fracture ... Read more
Reader Question:
Here's Your Chance to Practice ICD-10 Coding
Question: I have heard that there will be a test period for using ICD-10 codes on claims... Read more
Reader Question:
O-A and A-O Joints Are Same as Paravertebral Levels
Question:  Our physician administered four injections for a patient: RT C2-C3... Read more
You Be the Coder:
Keeping Tabs on When Modifier 59 Is Allowed
Question: We were just notified that modifier 59 is no longer accepted by Medicare payer... Read more