Minnie Posted Tue 13th of July, 2010 21:41:14 PM
How should an anesthesiologist bill for IV-PCA on the day of surgery and its management after the day of surgery?
Are these procedures reimbursable by Medicare, Blue Cross? Your input is greatly appreciated!
SuperCoder Answered Wed 14th of July, 2010 12:38:29 PM
Some carriers reimburse for PCA, but others (such as Medicare) do not. Begin by verifying the carrier’s policy regarding PCA payment so you can code according to those guidelines and some carriers require 01999 for PCA other require 99231. Select from initial inpatient consultation codes 99221-99223 for the first day and 99231 for the following days. Chances are the IV start is bundled with the initial consult (Medicare, for example, bundles the IV start). That means you wouldn’t code separately for it, but verify this with the carrier as well. If the carrier allows you to bill both services, append modifier -25 to the E/M code.
Mary Answered Wed 14th of July, 2010 13:32:40 PM