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Anesthesia Coding Alert

Reader Question:

Endotracheal Tubes

Question: The anesthesiologists in our group bill for endotracheal tubes for obese patients on a fairly regular basis. It is a billable service, using code 31500 (intubation, endotracheal, emergency procedure), but our carriers dont always pay for it. Do you have any suggestions for other ways we should code the procedure to get paid?

Sharon Cooper
Office Manager, Findlay Anesthesia
Findlay, Ohio

Answer: If you are using a diagnosis of obesity with your claim, it is possible that your carrier is not seeing the relationship between the obesity code and the endotracheal intubation. In such cases, it is best to code to the immediate symptoms that prompted the call for an endotracheal tube placement. Diagnosis code 786.09 (respiratory distress/insufficiency) would be a correct code in this situation.

If the intubation is noted as stat or emergent, you want to use 518.82 (acute respiratory distress/insufficiency) or 518.81 (acute respiratory failure) as the diagnosis. The diagnosis code you choose will depend on the main symptoms documented on the patients chart by the anesthesiologist or CRNA who placed the endotracheal tube.