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Anesthesia Coding Alert

Pain Management Corner:
Double-Check Your Options for Extremity Injections -- Here's Why
Tip: 64450 might be the best bet for some less common procedures Making your way through... Read more
Line Coding Know-How:
Learn the Ins and Outs of A-Lines to Achieve Accuracy
Documentation helps direct whether you bill separately You can usually code invasive li... Read more
New Policy:
Check ZIP Code to Combat Some Denials
Those extra four digits can really make a difference If you suddenly begin receiving den... Read more
Reader Question:
Field Avoidance Explained
Question: One of our new physicians checked "field avoidance" on the superbill. What exac... Read more
Reader Question:
Verify Carrier Policy for Unbundling EEG
Question: Can we report 95955 in addition to the anesthesia code? I understand it's an in... Read more
Reader Question:
Interpretation Matches Injection for 62290
Question: My physician heard that he can charge 72295 with each level of discography in a... Read more
Reader Question:
Consult-vs.-Established Guideline
Question: A primary-care physician referred a patient to our pain management practice for... Read more
Reader Question:
Lack of Fluoro Could Get Injections Denied
Question: One of our pain management physicians performs facet injections in the office w... Read more
Reader Question:
Consider Continuous Paravertebral Block Choices
Question: How should I code a continuous paravertebral block? West Virginia Subscriber ... Read more
Reader Question:
Turn to TPI for Piriformis Injection
Question: What code should I submit for a piriformis muscle injection used for pain mana... Read more
You Be the Coder:
Pinpoint Correct Use for V46.11
Question: Our physician provided anesthesia while another physician inserted a vertebral... Read more
ICD-9 Tips:
3 Strategies Help You Pinpoint the Right Diagnosis Codes
Signs and symptoms may sometimes be your best -- or only -- choice Choosing the right CP... Read more
Pain Management Corner:
Shoulder Snafu: Does Injection Count as Trunk or Limb?
Follow our experts' advice for this reader's question Sometimes the most difficult part... Read more
LCD Lookout:
Know Your Carrier's Stance on Counting Injections
Know Your Carrier's Stance on Counting Injections Knowing your carriers' positions on pr... Read more
Reader Question:
Look at 20552 or 90772 for Deep Muscle Injection
Question: How should I code deep muscle injections into the quadratus lumborum and psoas ... Read more
Reader Question:
Complexity Marks Thoracic Anesthesia Codes
Question: Four anesthesia codes describe anesthesia for procedures on the thoracic spine ... Read more
Reader Question:
Remember 59 for Medicare TEE
Question: Does Medicare have certain payment criteria for transesophageal echocardiograph... Read more
Reader Question:
Epidural Coding Depends on Documentation
Question: Our physician placed an epidural as part of the anesthesia technique along with... Read more
Reader Question:
Fall to Alternative Code for Hip ORIF
Question: The anesthesia record documents a fractured hip with an ORIF (open reduction in... Read more
Reader Question:
Technique Narrows Nephrostomy Options
Question: What code should I submit for nephrostomy tube placement with CT guidance? New... Read more
You Be the Coder:
Carrier Helps Guide Modifier 53 Claims
Question: My provider had much difficulty with needle placement for a cervical transforam... Read more
Pain Management Corner:
Get Paid for Fluoro Guidance With Spinal Injection -- Here's How
Use these 3 tips to help educate your carriers    Correctly billing fluor... Read more
Compliance:
Discover if You Can Capitalize on 1-Year NPI Extension
CMS admits defeat, promises progress on NPI sharing  Good news: You'll have an extra ... Read more
Audit Strategies:
Find Hidden Revenue in Common Code Claims
Experts: Insurers are paying added attention to modifier 25, 59 claims If you're not ... Read more
Reader Question:
N Tube Rarely Counts as Separate Service
 Question: Can we bill for nasogastric tube placement along with anesthesia during th... Read more
Reader Question:
SMP Equals RSD
 Question: Which diagnosis applies to sympathetically maintained pain? Is it the same... Read more
Reader Question:
00520 Works for Pacemaker Lead Removal
 Question: Is 00530 the best anesthesia code for removal of an infected pacemaker lea... Read more
Reader Question:
Even Pain Management Can Use Higher E/M Codes
 Question: I'm new to pain management coding, and am learning how to use the differen... Read more
Reader Question:
Cardiac Anesthesia Includes Hypothermia Code
 Question: Can we code induced hypothermia and hypotension in addition to anesthesia ... Read more
Reader Question:
Sodium Bicarbonate Might Not Be Worth Coding
 Question: Our provider sometimes administers sodium bicarbonate to help lessen the... Read more
Reader Question:
Don't Try to Interchange 354.0 and 354.1
 Question: What's the difference between 354.0 and 354.1? Carriers seem more likely t... Read more
You Be The Coder:
RFA of SI Nerve Branches
 Question: How should I bill for radiofrequency of the sacroiliac (SI) nerve branches... Read more
CCI Update:
Pay Attention to Version 13.2 Edit Deletions -- There's More There Than You Think
 Q3 changes expand percutaneous vertebroplasty, disc decompression options  ... Read more
Carrier Bulletin:
You Can Be Paid for Single-Vial Wastage From Biologicals
Good news: Policy update clarifies Medicare's stance In a policy revision effective J... Read more
Modifier Magic:
Learn the Cure for Your Modifier 52-53 Headaches
Documentation paves the way for discontinued, reduced claims success   &nbs... Read more
Payment Correction:
CMS Fixes Base Value Error
You'll get paid more for 00797CMS re-evaluated code 00797 (Anesthesia for intraperitoneal ... Read more
Reader Question:
Code Dysphagia First, Then Existing Cancer
Code Dysphagia First, Then Existing Cancer Question: A patient underwent esophagoscop... Read more
Reader Question:
Go With 01961 for C-Section, Nothing for Injection
 Question: Our anesthesiologist administered spinal anesthesia for a cesarean section... Read more
Reader Question:
00537 Works for NIPS
 Question: What are the surgical and anesthesia codes for NIPS?Illinois Subscriber&nb... Read more
Reader Question:
Just Code Cysto, Even With Other Services
 Question: Our anesthesiologist provided service while a patient had a cystoscopy, re... Read more
Reader Question:
Tendon Injection for L5-S1 Transverse Process
 Question: Our physician's dictation states, "At the junction of the L5 transverse pr... Read more
Reader Question:
Report 348.8 and 01990 for Organ Harvest
 Question: A patient who had been declared brain-dead was taken to surgery for harv... Read more
Reader Question:
Look to 'Unlisted' for Stellate Ganglion Destruction
 Question: What code should we use for neurolytic destruction of the stellate ganglio... Read more
Reader Question:
01905 Is Best for Vertebroplasty
 Question: What is the anesthesia code for lumbar vertebroplasty? One coder in our of... Read more
You Be the Coder
Paracoccygeal Nerve Block  Question: Our pain specialist injected lidocaine without ... Read more
Documentation Details ~ Beef Up Your MD's Consult Documentation
You can request consults from same-group colleagues, but watch frequency You may have spot... Read more
Pain Management Corner ~ Experts Weigh In on Chronic Conditions and E/M Levels
Medical history can be your stepping stone to 99214  The 1997 documentation guidelin... Read more
Diagnosis Watch ~ Keep Your Eyes Open for Chronic Conditions
Home in on these conditions that might be considered 'chronic' ICD-9 includes diagnoses f... Read more
Education Clue-in ~ Accomplish CEU Goals Using Publications You Receive
This summary can put you closer to reaching your renewal requirement If you're a Certified... Read more
Reader Question ~ HCPCS A4300, A4301 Equal CPT 36556
Question: Does HCPCS codes have a code to correspond to CPT 36556 ? Our carrier denies the... Read more
Reader Question ~ Report 00400 or 00540 for Sternal Wire Removals
Question: What surgical and anesthesia codes should I report for sternal wire extrusion? F... Read more
Reader Question ~ Watch Location for Spinal Plus Epidural
Question: Our anesthesiologist administered spinal anesthesia during a patient's hip repla... Read more
Reader Question ~ Check Behind Nurses Who File Claims for You
Question: I'm a CRNA, but recovery room nurses process our procedure codes. The program do... Read more
Reader Question ~ Say Yes to Fluoro Guidance for Hip Injections
Question: Can we submit 77002 for hip injections of cortisone and lidocaine? The code does... Read more
Reader Question ~ Counting Tactic Changes for Block vs. Destruction
Question: Our physician performs paravertebral facet joint injections. Would you clarify h... Read more
You Be the Coder ~ Nerve Block With Botox
Question: How should I code nerve blocks to the median, ulnar, radial sensory, posterior t... Read more
Pain Management Corner:
Migraine Coding Doesn't Have to Give You a Headache
Physician service--not diagnosis--drives your codingYou can report an E/M visit when your ... Read more
Terminology Check:
All Migraines Are Not the Same
Intractable vs. non-intractable can set your reimbursement success Before coding for... Read more
News Flash:
Get Ready for Sedation Pay With 1 Carrier
UnitedHealthcare to reimburse moderate sedation for most casesUnitedHealthcare (UHC) will ... Read more
ICD-9 Preview:
New Dx Codes Might Help Justify Services--and Pay
Cardiac history boosts your chances of successNew ICD-9 changes that go into effect Oct. 1... Read more
READER QUESTIONS:
CPT Has 22526, 22527 for IDET
Question: What procedure codes should we report for IDET (intradiscal electrothermal ann... Read more
READER QUESTIONS:
Code Colostomy Takedown by Location
Question: What surgical and anesthesia codes should I report for a colostomy takedown? ... Read more
READER QUESTIONS:
Avoid Automatic Resends of Denials
Question: When we know that the carrier has made a mistake in denying a claim, can we simp... Read more
READER QUESTIONS:
E/M Work Units Should Include Prescription Writing
Question: I heard that there's a code we can bill (and be paid for) to indicate when our p... Read more
READER QUESTIONS:
Watch Your Choices for Post-Op Blocks
Question: What procedure and diagnosis codes should I submit for femoral or interscalene p... Read more
READER QUESTIONS:
Verify if 21740 Applies to Sternum Repair
Question: Our patient had an unstable sternum, so the surgeon repaired it by attaching ste... Read more
READER QUESTIONS:
99100 Means 71 or Older
Question: What guidelines should I follow when reporting 99100 for extreme age? Nevada Sub... Read more
READER QUESTIONS:
'Unlisted' Is Your Answer for Extremity Chemodenervation
Question: Can we bill more than one unit for chemodenervation of the eccrine glands (other... Read more
You Be the Coder:
Reporting Bilateral Ablations
Question: How should I code bilateral ablations of the paravertebral facet joint at L3 thr... Read more
Pain Management Corner:
4 Simple Ways to Make the Most of Your Injection Claims
Train physicians to clearly document the muscles--so you can code correctlyYour pain manag... Read more
Up-Front Documentation:
Distinguishing Between ABNs And NEMBs Equal Clean Claims
Follow these steps to use the right form every timeIdeally, Medicare reimburses your anest... Read more
Collections Corner:
Discover 8 Fresh Ideas for Finding Untapped Revenue
Turn a negative into a positive with these quick stepsKeeping your physicians from taking ... Read more
READER QUESTIONS:
Sift Through Symphysis Pubis Injection Choices
Question: How should I code a symphysis pubis injection? Oregon Subscriber ... Read more
READER QUESTIONS:
Go With 'Unlisted' for Intradiscal Injection
Question: Our pain specialist injected a disc's nucleus with an anesthetic agent and a ste... Read more
READER QUESTIONS:
Capture Everything With Multiple Services and TEE
Question: Our physician provided anesthesia during a triple bypass vein graft (off pump). ... Read more
READER QUESTIONS:
Avoid Bilateral Modifiers With 64613
Question: My physician injected five muscles on both sides of the patient's neck, all bila... Read more
READER QUESTIONS:
Infusion Pump Injection and Evaluation
Question: Our pain specialist used fluoroscopy to inject medication into a patient's infus... Read more
READER QUESTIONS:
Situation Determines How You Code 2-CRNA L&D Case
Question: Two of our CRNAs provided anesthesia during a labor and delivery case. The first... Read more
You Be the Coder:
Sedation During PICU Procedures
Question: Some of our physicians in the pediatric intensive care unit (PICU) perform sedat... Read more
Details Count:
Save Time and Trouble by Using ABNs Correctly
Know when and how to rely on this tool ‧‧ but don't expect to always get paid ... Read more
Test Yourself:
Check Your ABN Knowledge
Be alert for situations that require ABNs -- and those that don't      ... Read more
NCCI Update:
Watch for These Anesthesia Changes in Version 13.1
Pay particular attention to your T-code claims -- they take the biggest hit    &... Read more
READER QUESTIONS:
Damage Determines Biceps Tear Diagnosis
Question: What diagnosis should I report for a biceps tear? I haven't found it in ICD-9's ... Read more
READER QUESTIONS:
Code Conjoined-Twins Case Separately
Question: Two of our anesthesiologists participated in a cased of separating 2-year-old co... Read more
READER QUESTIONS:
Catheter Placement and Follow-ups
Question: Our pain specialist placed a patient's lumbar epidural catheter on Monday and ad... Read more
READER QUESTIONS:
Separate Times to Make Separate Payments Easier
Question: How should I separate anesthesia charges for nasal repair procedures (such as 30... Read more
READER QUESTIONS:
Confirm Approach for Translaminar Epidural
Question: How should I code a translaminar epidural? Washington Subscriber    &n... Read more
READER QUESTIONS:
Verify Carrier Requirements for Occipital Injection
Question: Several carriers deny our claims for greater occipital nerve blocks with 64405. ... Read more
READER QUESTIONS:
01991, 01992 Cover CRNA Assist With PM
Question: A CRNA helps our pain management specialist on procedure days in the office. She... Read more
You Be the Coder:
Catch All Time With Vaginal/C-Section Case
Question: How should I report time on a single claim when a patient converts from a vagina... Read more
L&D Coding:
Yes, You Can Be Paid for Standby -- if You Follow the Rules
Check documentation details before approaching carriersCPT's E/M section includes one code... Read more
Pain Management Corner:
Follow These FAQs to the Best Diagnosis for PM Patients
Tip: Don't limit yourself to just one ICD-9 code If you don't know what differentiates an ... Read more
E/M Coding:
Achieve the Correct HPI Level Every Time -- Here's How
Watch these 8 areas to paint a clear picture of the patient's situation Understanding each... Read more
You be the coder:
Watch crosswalks for node excision
Question: What surgical and anesthesia codes apply to supraclavicular lymph node excisio... Read more
Reader question:
Billing secondary for Part A patients
Question: Our pain management specialist saw a patient in the hospital. The patient had on... Read more
Reader Question:
Lumbar Facet Code Depends on Position
Question: Our anesthesiologist provided service while a pain specialist in our group admin... Read more
Reader Question:
Patient-Generated Opinion Doesn't Equal Consult
Question: I know that CPT deleted the confirmatory consult codes for billing second opinio... Read more
Reader Question:
Several Options Apply for Prostate Seed Implant
Question: What anesthesia code should I submit for prostate seed implant?Kansas Subscriber... Read more
Reader Question:
Look to Epidural Codes for Baclofen Injection
Question: How should I report an intrathecal Baclofen injection administered in an outpati... Read more
Reader Question:
Untangle Incident-to and TP Indicators
Question: How should I code incident-to services when our pain management specialist is in... Read more
NEWS BRIEF ~ Congress Averts CF Payment Cut, but Hold Off on Your Celebrations
Check local ACF to see what you'll really submit Congress froze the expected 5 percent pay... Read more
PAIN MANAGEMENT CORNER ~ IDET Gets CPT Codes, but Don't Assume You'll Get Paid
Our experts provide surefire strategies for working with carrier policies  If yo... Read more
CODING KNOW-HOW ~ Coding for IDET? Nuances Can Make All the Difference
Keep these details in mind to keep your claims on track If your pain management specialist... Read more
COMPLIANCE CHECKPOINT ~ Acquire NPI Numbers for Your MDs -- Before It's Too Late
National Provider Identifiers kick in this spring, so make sure you're ready The clock is... Read more
YOU BE THE CODER ~ Ear Tube Removal and Insertion
Question: How should I code for anesthesia during removal and replacement of ear tubes? ... Read more
READER QUESTION ~ Remember Modifier 52 for Single Lumbar Block
Question: Our pain management specialist administered a single lumbar plexus block. How ... Read more
CLARIFICATION
Julee Shiley, CPC, CCS-P, CMC, ACS-AN, a source for "Essential Tips for EGD Anesthesia Cod... Read more
READER QUESTION ~ Watch Other Procedures to Determine ICD Testing
Question: Our physician completed a charge ticket indicating implantable cardioverter defi... Read more
READER QUESTION ~ Look to 59 for Femoral, Popliteal Block Combo
Question: A new physician in our group sometimes administers a femoral nerve block and a p... Read more
READER QUESTION ~ V53.09 Does Apply to Stim Removal
Question: What diagnosis applies to removing a spinal cord stimulator (SCS) system? The pa... Read more
READER QUESTION ~ 00170 Works for Nasal Hemorrhage
Question: Our physician wrote "EUA [exam under anesthesia] control bleed" in the notes for... Read more
READER QUESTION ~ Rely on 01922 for Radiotherapy
Question: Our physician provided monitored anesthesia care (MAC) during radiotherapy for a... Read more
CODING HOT BUTTON ~ Essential Tips for EGD Anesthesia
What you need to know before filing claims  Providing anesthesia during esophagogast... Read more
PAIN MANAGEMENT CORNER ~ Test Your ROS Knowledge for More Accurate Claims
2 scenarios help hone your E/M coding skills E/M visits are an important part of pain man... Read more
DRUG WARNING ~ FDA Releases Alert on Using Methadone for Pain Mgmt
Click to read the full warning The FDA recently released a warning on methadone used for p... Read more
READER QUESTION ~ Be Wary of Acupuncture Claims Submission
Question: One of our pain management physicians is beginning to offer acupuncture services... Read more
READER QUESTION ~ Groin Mass Diagnosis Could Be 782.2
Question: What diagnosis code should I report for a groin mass? Mississippi SubscriberAnsw... Read more
READER QUESTION ~ Region Determines Interlaminar Epidural Code
Question: What should I submit for an interlaminar epidural injection? Nebraska Subscriber... Read more
READER QUESTION ~ Think Twice Before Coding Sternal Wire Removal
Question: How should I code sternal wire removal? The diagnosis is ICD-9 996.79 (Other com... Read more
READER QUESTION ~ Use 00566 Only for Non-Pump CABG
Question: When should I report 00566 for coronary artery bypass graft (CABG) procedures in... Read more
READER QUESTION ~ Count Levels, Not Nerves, for Block
Question: Our provider documented that he administered a nerve block to the left side of C... Read more
READER QUESTION ~ How to Code Epidurals Without Fluoro
Question: Our physiatrist wants to administer epidurals in our office (a non-surgical faci... Read more
READER QUESTION ~ Get Approval Before Coding Racz Procedure
Question: Coders in our office disagree on the best code for an anterior approach Racz pro... Read more
YOU BE THE CODER ~ Check Options for Aortic Valve Replacement
Question: What anesthesia code is best for an aortic valve replacement? Another coder sugg... Read more
NEWS BRIEF ~ 2007 Conversion Factor Cuts Will Wreak Havoc on Your Bottom Line
Anesthesiologists and PM specialists will see the effects Whether your group focuses on a... Read more
PAIN MANAGEMENT CORNER ~ Recoup Reimbursement for Long-Term CTS Treatment
Documentation is the key to success  When a patient’s carpal tunnel syndro... Read more
CLARIFICATION ~ Report Facet Blocks and Multilevel Injections With Ease
Enhance your coding with expanded answers to 2 reader questions  Subscribers rai... Read more
READER QUESTIONS ~ Verify Documentation Before Reporting 36410
Question: Can we bill separately for a single IV start that is separate from anesthesia de... Read more
READER QUESTION ~ Add Modifier 59 to CSF Drain Catheter
Question: Our anesthesiologist placed a cerebral spinal fluid (CSF) drain catheter while p... Read more
READER QUESTION ~ Sift Through Modifier Choices for OR Return
Question: A patient returned to the operating room because of postoperative bleeding after... Read more
READER QUESTION ~ Appeal Denials for Multiple NCS Claims
Question: Our pain management specialist often conducts multiple sensory and/or motor nerv... Read more
READER QUESTION ~ 1-Time vs. Continuous Determines Femoral Block
Question: How should we report a single femoral nerve block (as opposed to a tunneled inse... Read more
YOU BE THE CODER ~ Try Specific Dx for Cervical Facet Arthritis
Question: What diagnosis should I report for cervical facet arthritis? Washington Subscrib... Read more
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