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Anesthesia Coding Alert

2006 Update:

CPT Introduces New Codes for Abortion Anesthesia

Published on Sun Jan 01, 2006

Understand the differences between 2 reporting options

CPT 2006 incorporates only two new codes in the anesthesia section, both related to abortion procedures. Be sure you know what each of the codes represents before submitting either of them.

The new edition, effective Jan. 1, deletes 01964 (Anesthesia for abortion procedures) and replaces it with two more specific codes: 01965 (Anesthesia for incomplete or missed abortion procedures) and 01966 (Anesthesia for induced abortion procedures).

Definition difference: An -induced- abortion is an elective case, while an -incomplete or missed- abortion is not (such as a miscarriage). Some insurers  pay only for medically necessary procedures. An elective abortion might not be medically necessary, so some carriers might not pay for it.

Example 1: A 24-year-old patient who is 16 weeks pregnant comes to the hospital after having severe cramping and bleeding for three days. Report 01965 because the patient had a miscarriage.

Example 2: An 18-year-old patient who is six weeks pregnant comes to the hospital to terminate the pregnancy. The procedure is elective rather than medically necessary, so you would report 01966.
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