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Anesthesia Coding Alert

Anesthesia Basics:
Refresh Your Swan-Ganz Coding Knowledge with These 3 Q&As;
Hint: Swan-Ganz usually overrides other special line placements. Most line placements are... Read more
Terminology Check:
Remember What a Swan-Ganz Catheter Does
Pay attention to other names for it, too. A Swan-Ganz catheter (SGC) is designed for spec... Read more
Policy Update:
Acupuncture Coverage Could Become a Reality for Medicare
Proposed trial period would study benefits for chronic low back pain. If you sometimes co... Read more
Don’t Let Incidental PHI Disclosure Lead to Bigger Compliance Issues
Set practice thresholds and train employees to potentially prevent breaches. Ensuring tha... Read more
Reader Question:
Steer Clear of Reporting Consults for Pre-op Evaluations
Question: A CRNA performed a consult history and physical within 30 days of the plann... Read more
Reader Question:
Verify Continuous Infusion for 01967 to +01968 Shift
Question: A patient received an epidural that our provider noted as code 01967 for the fir... Read more
Reader Question:
‘With Anesthesia’ Includes General and MAC
Question: We're having some confusion in our office about CPT® codes such as 23655 with d... Read more
Reader Question:
Turn to 00300 for Baer Hearing Study Anesthesia
Question: What is the correct anesthesia code for a Baer hearing study? Louisiana Subscri... Read more
Reader Question:
Establish a Policy for Reimbursing CRNAs During Shared Cases
Question: We sometimes use just CRNAs during surgical procedures and append modifier QZ to... Read more
Reader Question:
Brush Up on Terminology to Understand Bilateral Notes
Question: An established patient who has a temporomandibular joint (TMJ) disorder reports ... Read more
You Be the Coder:
Remember This Before Reporting 99360
Question: I am looking for some direction in billing for local anesthesia when patient has... Read more
Anesthesia Basics:
Refresh Your Time Calculation Savvy With These 3 Scenarios
Remember every unit is critical to anesthesia claims success. Time calculation is an inte... Read more
Coding Update:
Get Ready for New CPT® Codes That Could Change Your Reporting in 2020
Tip: Pay special attention if you sometimes report pain management services. Fall is here... Read more
Prepare for Stricter Medicare Provider Enrollment, Thanks to New Rule
CMS will have greater authority to deny or revoke enrollment. The trend toward deregulati... Read more
Reader Question:
Append Modifier QZ for CRNA Without Medical Direction
Question: Our facility does not have an anesthesiologist on staff so relies on CRNAs. A no... Read more
Reader Question:
Turn to E/M Codes in Certain Scenarios Before Induction
Question: A patient with a stab wound to the right chest wall (with hemopneumothorax) was ... Read more
Reader Question:
Include Clear Documentation of Anesthesia During Extubation
Question: Is it possible to charge for an extubation procedure? The surgeon did the extuba... Read more
Reader Question:
Negotiate with Private Payers Before Submitting 95955 with Anesthesia Code
Question: Some anesthesiologists in our area are billing 95955 in addition to the procedur... Read more
Reader Question:
Only Report Z99.11 as a Secondary Diagnosis
Question: Our physician provided anesthesia while another physician inserted a vertebral a... Read more
Reader Question:
Cardiac Bypass Anesthesia Includes +99116 and +99135
Question: Can we code for induced hypothermia and hypotension in addition to anesthesia du... Read more
Reader Question:
C-section and Bowel Repair During Same Session
Question: A patient went to the OR for a C-section due to bowel obstruction. Can we bill f... Read more
You Be the Coder:
Here’s How to Bill Your Teaching Physician’s Service
Question: We currently have a medical student working with us at our clinic. In patient en... Read more
Special Circumstances:
Clarify What Qualifies as ‘Emergency’ Before Coding with +99140
Remember the situation is the determinant, not the location. Certain circumstances can so... Read more
Fee Schedule:
Watch for Little Change to Your CMS Reimbursement in CY 2020
Anesthesia conversion factor remains virtually the same. Changes will soon be afoot for r... Read more
Follow These 4 Tips—Not the Myths—to Better HIPAA Compliance
Pay prices upfront to avoid bigger costs later. Many practices (or covered entities, CEs)... Read more
Reader Question:
Only Append Modifier 24 for Unrelated Care During Post-op Period
Question: I need some help in figuring out what we can bill for our involvement with post-... Read more
Reader Question:
Be Sure L&D Code Captures the Correct Level of Service
Question: I am coding for a patient who did not have labor analgesic. She did have anesthe... Read more
Reader Question:
Watch Mode of Anesthesia Before Reporting 62322
Question: The anesthesiologist placed a single-injection intrathecal block to interspace L... Read more
Reader Question:
Remember That 64616 Doesn’t Qualify for ‘Bilateral’
Question: When our physicians administer Botox for chronic migraines, we bill the HCPCS J ... Read more
Reader Question:
Choose from G21 Family for Secondary Parkinsonism
Question: I know that certain conditions can affect anesthesia administration, especially ... Read more
You Be the Coder:
Turn to This Code for Single-shot Cervical Epidural
Question: The physician gave the patient a single-level cervical transforaminal epidural t... Read more
Anesthesia Basics:
Don’t Get Muddled Over Moderate Sedation Coding
Keep 4 things in mind when deciding whether you can report the service. Hearing multiple ... Read more
Code Corner:
Choose from These Codes When Reporting Moderate Sedation
Caveat: Have clear documentation that the codes apply. CPT® 2019 includes six codes for ... Read more
Procedure Focus:
Are You Up to Date on TPI Coding? Find Out Before It’s Too Late
Plus: Keep this list of potential associated diagnoses handy. Even if you don't code for ... Read more
Technology News:
CMS Makes a Move to Close Communication Gaps
Here's the scoop on the newest way to share data. The Centers for Medicare & Medicaid... Read more
Reader Question:
Begin With 36902 to Cross to Anesthesia for Dialysis Circuit
Question: What is the correct way to code for anesthesia related to angioplasty on a ... Read more
Reader Question:
‘Unlisted’ Is Your Option for Anesthesia During Nasogastric Tube Placement
Question: I bill for a children's hospital and a small child was brought to the OR and ane... Read more
Reader Question:
Remember That 62263 Covers Multiple Days of Treatment
Question: My physician performed an epidural lysis and administered three injections over ... Read more
Reader Question:
Choose Correctly Between Modifiers QY and QX
Question: I'm coding for a procedure that included an anesthesi­ologist and CRNA. Can you... Read more
Reader Question:
Don’t Try to Bill Anesthesia for Fetus During Mom’s Surgery
Question: An expectant mother was given general anesthesia during a procedure. The fetus (... Read more
Reader Question:
Append Modifier 23 to Explain Unusual Anesthesia
Question: A patient needed general anesthesia during an EEG due to behavioral issues and a... Read more
You Be the Coder:
Submit This Code for Axillary Sentinel Node Biopsy
Question: The surgeon performed an axilliary sentinel node biopsy in conjunction with... Read more
Code Update:
Don’t Let the Latest CCI Edits Slip Past Your Notice
Hint: Pay special attention if you report pain management services. The latest Correct Co... Read more
Get a First Look at Diagnosis Changes for 2020
Every code can help justify your anesthesia provider's service. The initial information a... Read more
HHS Switches Up Your Potential HIPAA Breach Penalty Fees
Big changes to annual limits are being implemented. In an announcement that shocked provi... Read more
Reader Question:
Management Code 01996 Can Go With Continuous Block Codes
Question: One of our providers asked a question about the daily management codes asso... Read more
Reader Question:
Verify Intrathecal Block’s Purpose Before Coding
Question: Our anesthesiologist administered a single injection intrathecal block duri... Read more
Reader Question:
Remember the Requirements for Moderate Sedation
Question: Our physicians do not normally use moderate sedation, so I'm not accustomed... Read more
Reader Question:
POS 11 Is a Legitimate Place for Anesthesia Services
Question: My anesthesiologist has been asked to perform anesthesia in an office surgi... Read more
Reader Question:
Remember You Can’t Buy HIPAA Compliance
Question: Our office recently purchased encryption software that claims to be “100-... Read more
You Be the Coder:
Know How to Choose Between 01992 and 01936
Question: Is it appropriate to report 01992 with 01936, or are they inclusive of each... Read more
Modifier Refresher, 01999:
Don’t Let ‘Discontinued’ Derail Your Claims
Follow 3 steps to keep modifier 53 claims on the right track. Surgeons and anesthesiologi... Read more
Pain Management:
Get Clear on Diagnosis Options for Spinal Stenosis
Hint: Pay close attention to the specific area affected. Coding for a patient who's been ... Read more
Say Goodbye to 1 Phase of HIPAA Security Programs
‘Phase 2' of the audit program is no longer in effect. After being inundated with HIPAA... Read more
Reader Question:
Check Purpose of Epidural Before Reporting Anesthesia Services
Question: Are we allowed to bill MAC anesthesia for a caudal epidural that was administere... Read more
Reader Question:
Consider 01996 for Postoperative Pain Management Check
Question: Is it appropriate to bill 99231 when our anesthesiologist visits the patient at ... Read more
Reader Question:
Watch for Combination Diagnosis if Multiples Are Denied
Question: A private insurer has denied our claim for a pain management office visit f... Read more
Reader Question:
Make Note of Dates When Anesthesia Service Changes After Midnight
Question: I am billing an OB case that started as a continuous labor epidural for a planne... Read more
Reader Question:
Verify That You’re Selecting the Correct Crosswalk Code
Question: Our physician administered anesthesia while another physician inserted a vertebr... Read more
Reader Question:
01990 Represents Anesthesia Support During Organ Harvest
Question: The anesthesiologist was present when a patient who had been declared brain-dead... Read more
Reader Question:
M62 Family Has Diagnoses for Nontraumatic Biceps Rupture
Question: The anesthesiologist documented “repair of biceps tear” as the procedure per... Read more
You Be the Coder:
Turn to This Code for Anesthesia During Kyphoplasty
Question: One of our doctors is questioning whether 01936 accurately reflects the work of ... Read more
Let Your Diagnoses Help Support Medical Necessity
Watch circumstances and payer policies to bolster your chances. Documentation is always k... Read more
Know the Official Stance on Medical Necessity
Get familiar with AMA and CMS viewpoints. According to the American Medical Association's... Read more
Keep Staff Trained to Keep Yourself Free From HIPAA Trouble
Start with clear explanations of what constitutes PHI. Just because the term “HIPAA” ... Read more
Follow 5 Steps to Keep Your MIPS Files on Track
Hint: Old fashioned organization is your key to success. The potential for audits has bee... Read more
Reader Question:
Search for a Primary Diagnosis to Report With Z99.11
Question: Our anesthesiologist provided anesthesia while another physician inserted a vert... Read more
Reader Question:
Spinal Anesthesia Outranks Intrathecal Injection In Terms of Coding
Question: The anesthesiologist administered an intrathecal morphine injection in conjuncti... Read more
Reader Question:
Code 01936 Is Probably Best for Anesthesia During Kyphoplasty
Question: One of our doctors is questioning whether 01936 accurately reflects the work of ... Read more
Reader Question:
Know Your Best Options for Anesthesia During TEE
Question: I have a CRNA who wants to bill 93318 for his part in a TEE procedure, but anoth... Read more
Reader Question:
Procedure Code Overrides Intubation and Vent Management
Question: The anesthesiologist intubated a patient, performed ventilation assistance/manag... Read more
You Be the Coder:
Append the Correct Modifier for CRNA’s Work
Question: Our CRNA documented that she administered an epidural steroid injection under an... Read more
Procedure Focus:
Follow This Refresher to Smoother GI Endoscopy Claims
Don't forget to factor in the MAC possibility. Coding for anesthesia during gastrointesti... Read more
Brush Up on Medical Necessity for MAC
Check out this payer's example of criteria to meet. Although colonoscopy screening is a p... Read more
Strengthen Your Security Against Ransomware Attacks
Tip: Even simple staff training can help make a difference. If you think your practice is... Read more
Get Your Latest CMS News Via Podcast
Feds continue to go mainstream with information sharing. If you're a podcast fan, you now... Read more
Reader Question:
Check Line Placement to Correctly Code Central Line With Swan-Ganz
Question: Our anesthesiologist recently documented that we should code for a central line,... Read more
Reader Question:
Report 64555 for Trial Occipital Nerve Stimulator
Question: Our pain management specialist placed a dual 8-electrode occipital stimulator su... Read more
Reader Question:
Don’t Try to Find a Code for MAC
Question: I'm new to anesthesia coding and have heard quite a bit about monitored anesthes... Read more
Reader Question:
Diagnosis M51.16 Covers the Symptoms of M51.26
Question: A payer has denied our claim for a pain management office visit with the reason ... Read more
Reader Question:
Watch Your Claims for Anesthesia During TEE
Question: Are there new coding edits associated with billing 93312, 93320, and 93325 for a... Read more
You Be the Coder:
Allocating Time Units Between Providers
Question: A non-medically directed CRNA took the patient into the operating room. He place... Read more
Coding 101:
Remember the Rules for Reporting Field Avoidance
Hint: It's all about the number “5.” Accounting for field avoidance might not be in y... Read more
Coding Edits:
Don’t Miss Out on Payment for Spinal Arthrodesis
Pay special attention to spaces and incision sites. The newest round of Correct Coding In... Read more
Do You Watch These 5 Areas for Audit Assurance?
Auditing is a necessity in the health care and coding world, whether you're a provider or ... Read more
Reader Question:
Report O34.219 for Repeat C-section
Question: A patient had a repeat Cesarean section due to pre-eclampsia. What is the c... Read more
Reader Question:
Paravertebral Facet Joint Injection Could Be 64490
Question: Our pain management specialist administered a cervical facet zygopophyseal intra... Read more
Reader Question:
Turn to These Modifiers When Reporting Medical Direction
Question: I'm still fairly new to anesthesia coding and want to be sure I'm adding the cor... Read more
Reader Question:
Code 76942 Has No Anesthesia Crosswalk
Question: One of our anesthesiologists insists there is an ASA code valued at one base uni... Read more
Reader Question:
Generally Say ‘No’ to Providing Anesthesia for Dental Procedures
Question: Can an anesthesiologist provide dental anesthesia for procedures such as dental ... Read more
Reader Question:
C-section Diagnosis Code Depends on First Time or Repeat
Question: I am billing for providers who only administer obstetrical anesthesia. What... Read more
You Be the Coder:
Choose From These Codes for Anesthesia During Colonoscopy
Question: Our CRNA was asked to provide anesthesia during a patient's colonoscopy. How do ... Read more
Postoperative Coding:
Survey These Scenarios to Score Success With Daily Hospital Management
Once again, documentation will make or break your claim. You can report postoperative ser... Read more
Pain Management:
Keep These Tips in Mind for Post-op Pain Care Coding
Pay attention to laterality and other factors. Code 01996 (Daily hospital management of e... Read more
Practice Management:
Follow 4 Tips for Self-Audit Success
Start by spotting possible trends, then expand from that point. Now that you're a couple ... Read more
MAC Update:
New LCD Rules Could Be in the Works
Check out this website for the latest info. Think you have a solid understanding of the L... Read more
Reader Question:
Reserve +64484 for Different Level of ESI
Question: I have some questions about billing for epidural steroid injections. Patient #1 ... Read more
Reader Question:
Episiotomy Work Is Included In L&D Epidural Code
Question: The anesthesiologist administered an epidural during a vaginal delivery. He foll... Read more
Reader Question:
Submit ‘Unlisted’ 64999 for Internal Pump Repositioning
Question: A patient has an implanted pain pump. She is not due for a replacement, but want... Read more
Reader Question:
Pay Attention to Guidance When Choosing Between 62322 and 62323
Question: What is the correct way to report a caudal ESI under ultrasound guidance? I'm co... Read more
Reader Question:
Payers Might Be Looking for Higher Level Comorbidities
Question: During a recent audit in our department, I was marked down for having too many d... Read more
You Be the Coder:
Pinpoint the Correct Arthroplasty Code
Question: Our pain management physician performed arthroplasty of a patient's finger joint... Read more
Coding Changes:
The First Coding Edits of 2019 Include 46,000 New Pairs: Are You Ready?
Tip: Focus on 99451 and 99452 and you'll be fine. Each year begins with a new set of Corr... Read more
Descriptor Check:
Do You Know What 99451 and 99452 Represent?
Here's your short answer. With so many CCI edits tying in with codes 99451 and 99452, it'... Read more
Reimbursement Update:
CMS Boosts Your Pay – Slightly – With 2019 Conversion Factors
The anesthesia starting point will be $22.2730. Anesthesia providers will see an uptick i... Read more
Pain Management:
Don’t Settle for the Simple ‘Pain’ Diagnosis
General is fine for a starting point, but be prepared to shift. Coding for pain syndromes... Read more
Reader Question:
Submit a Single Code, Even for Different Types of Anesthesia
Question: The anesthesiologist provided an epidural for a vaginal delivery, followed immed... Read more
Reader Question:
Here Are Your Options for Failed VBAC Followed by C-section
Question: A patient attempted a VBAC delivery but it failed due to fetal distress. She del... Read more
Reader Question:
Code 00300 Applies to Baer Hearing Study
Question: What is the appropriate anesthesia code for a Baer Hearing Study? Delaware Subs... Read more
Reader Question:
Only Bill 93503 When Swan-Ganz and Central Line Share Access Point
Question: One of our anesthesia providers asked me about how to code this scenario: Someon... Read more
Reader Question:
Timing Is Crucial for Discontinued Procedures
Question: Our anesthesiologist was scheduled to administer anesthesia during hardware plac... Read more
You Be the Coder:
Crossing Mediport Placement to Anesthesia
Question: I'm coding for a patient with breast cancer (C50.912, C77.3) who received a Medi... Read more
Coding Basics:
Start the New Year With a Firm Grasp of Medical Direction vs. Supervision
Hint: It's all about following the ‘7 rules.' One of the primary factors to consider wh... Read more
Focus on These Terms to Pinpoint Best Migraine Diagnosis
Remember, all symptoms don't lead to the same code. The detailed specificity of ICD-10 is... Read more
Reader Question:
Screening Designation Separates 00811 and 00812
Question: There is some confusion in our office about which anesthesia code we should use ... Read more
Reader Question:
Report Intubation Over Vent Management
Question: Can we bill Medicare for intubation (31500), ventilation assist/management (9400... Read more
Reader Question:
Code Only Epidural During Session That Includes MAC
Question: Our physician administered an epidural for a vaginal delivery, followed immediat... Read more
Reader Question:
Transforaminal Injection Code Overrides IV Sedation
Question: Our physician performs medial branch blocks and transforaminal injections in our... Read more
Reader Question:
Epidural Removal Time Is Individualized
Question: What amount of time should we include on the claim for epidural removal followin... Read more
Reader Question:
Check Patient Position When Choosing Between 01991 and 01992
Question: Which is the best anesthesia code for an SI joint injection? Wyoming Subscriber... Read more
Reader Question:
Watch the Elapsed Time Before Coding Repeat Injection
Question: Our pain management specialist saw a patient with complex regional pain syndrome... Read more
You Be the Coder:
The Difference Between 01935/36 and 01991/92
Question: Can you explain to me when I should report codes 01935/01936 and 01991/01992? Ou... Read more