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Anesthesia Coding Alert

Qualifying Circumstances:
Focus on 3 Checkpoints for Clean Hypothermia Claims
Tip: Digging deeper into descriptors will stop your coding errors cold. Qualifying cir... Read more
ICD-10:
Segregate Your Diabetes Mellitus Codes Based on Type
Hint: Use fourth and fifth digit expansion to specify complications. Diabetes can lead... Read more
Clip and Save:
Here's Your Heads Up on What HIPAA Auditors Want
Follow this checklist to be prepared before the audit letter arrives. As HIPAA audit f... Read more
Reader question:
Sedation Means Anesthesia Codes, Not 99148
Question: Our anesthesiologist used fentanyl and propofol to provide sedation during a c... Read more
Reader question:
Transforaminal Overrides Interlaminar ESI Code
Question: Our physician wants to bill for an aborted interlaminar epidural steroid injec... Read more
Reader question:
Check Global Period Before Coding Pain Pump Removal
Question: Our physician removed an implanted pain pump and catheter from a patient whose... Read more
Reader question:
Adding Extra Unit for Pre-Op H&P
Question: I have an anesthesiologist asking if a pre-op history and physical could be se... Read more
Reader question:
Ins and Outs of Coding Sinus Tarsi Injection
Question: We recently received a denial when we reported a cortisone injection to the si... Read more
Reader question:
Date of Service Determines Impact of Sequestration Cut
Question: Does the 2 percent sequestration cut apply to claims with dates of service on/... Read more
You Be the Coder:
Choosing Wisely for Sentinel Node Biopsy
Question: The surgeon performed an axillary sentinel node biopsy in conjunction with a p... Read more
CPT®2014;:
Prepare to Implement New and Revised PQRS Measures in 2014
Heads up: Don’t fret over hypothermia code shifts. CPT® 2014 won’t int... Read more
Qualifying Circumstances:
Brush Up on 4 Tips Before Reporting +99140 Emergency
Communicating with your provider is your best first step. Including qualifying circums... Read more
ICD-10:
Get Specifics About Pacemaker Adjustments for ICD-10 Success
Hint: Z45 family will draw lines between battery and other parts. When your anesthesia... Read more
Reader Question:
Surgical Approach Determines 00840 vs. 00944 Choice
Question: In the Anesthesia Crosswalk, CPT® code 58550 crosses to 00944, with 0... Read more
Reader Question:
Two Anesthesiologists, Two Anesthesia Methods
Question: An obstetrics patient had an epidural beginning at 1438 on September 2. S... Read more
Reader Question:
Try A4300 or A4301 if Payer Wants HCPCS Over CPT® 36556
Question: Is there a HCPCS code to correlate with CPT® code 36556? Our payer de... Read more
Reader Question:
Check Details Before Coding Blood Patch on Delivery Day
Question: How do I code an epidural blood patch procedure on the same day as labor ... Read more
Reader Question:
Get Patient Approval Before Disclosing PHI
Question: Who’s authorized to make a request to review a patient’s medi... Read more
You Be the Coder:
Modifiers ZA and ZC Explained
Question: Do you have any information on the correct use of modifiers ZA and ZC? I ... Read more
Modifier 22:
Watch for These Opportunities to Possibly Add -22 to Claims for Increased Services
Are you missing pay for your extra time? No two procedures are exactly the same, espec... Read more
Breaking News:
Here's Your Sneak Peek at Anesthesia Code Changes for CPT® 2014
Hint: You’ll find them all in Category II or III sections. The American Medical ... Read more
Spinal Procedures:
Set Your GPS to Vertebral Location and Navigate to Correct Vertebroplasty Codes
Plus: Check out the differences in AMA vs. Medicare viewpoints. The AMA and Medicare ... Read more
ICD-10:
Two C-Section Diagnoses Become One Under ICD-10
Heads up: Don’t forget to include an outcome code. When you report the unspecifi... Read more
Reader Question:
Check Crosswalks Before Choosing the Best Anesthesia Code
Question:  Our anesthesiologist was present during a procedure that started as an o... Read more
Reader Question:
Anesthesia Service Includes Monitoring of Vitals
Question:  Is there a billable code for monitoring oxygen and heart function during... Read more
Reader Question:
TAP Catheters Explained
Question: What is a TAP catheter, and how should we code for using one? Arizona Subs... Read more
Reader Question:
Focus on Joint Level for Facet Nerve Blocks
Question: I’m coding for bilateral intra-articular facet nerve blocks to L1, L2, a... Read more
Reader Question:
Date of Service Shows Your Effects From Sequestration Cut
Question: Does the 2 percent sequestration cut apply to claims with dates of service on/... Read more
You Be the Coder:
Moderate Sedation for Epidural Cath Placement
Question: My anesthesiologist completed an epidural catheter implantation under moderate... Read more
Diagnosis Coding:
Let V Codes Help You Gain Higher Reimbursement
Build your diagnosis codes by starting with subterms. Thinking that V code diagnoses m... Read more
2014 Physician Fee Schedule:
Proposed Changes Could Benefit You Next Year
Other news: Don’t miss your chance at $39,000 if you still haven’t joined th... Read more
ICD-10:
Continue to Focus on Gangrene and Obstruction to Untangle Umbilical Hernia Diagnoses
ICD-10 keeps 3 code choices for you. When your anesthesiologist is involved with a cas... Read more
Compliance:
Are You Reporting the Correct Group Practice Designation?
Brush up on the definitions to be sure. If you’re reporting quality data using ... Read more
Reader Question:
Report Failed Sedation With 995.24
Question: What diagnosis should we assign when our physician documents "failed seda... Read more
Reader Question:
3 Documented Nerve Blocks Leads to 64450 x 3
Question: Three blocks were given during a patient’s wrist procedure (listed in th... Read more
Reader Question:
CABG Case That Crosses from Off Pump to On Pump
Question: My anesthesiologist began a bypass case without the pump oxygenator, then went... Read more
Reader Question:
Multi-Level Transforaminal Injections Get Separate Line Units
Question: The pain management specialist administered three transforaminal epidural inje... Read more
Reader Question:
Moderate Sedation Is Allowed With Discogram
Question: Our physician sometimes provides anesthesia while performing a discogram. Is t... Read more
Reader Question:
Get the Scoop on Sending Unencrypted Emails
Question: I recently heard that the HIPAA privacy rule was changed and it now prohibits ... Read more
Reader Question:
Choose 64999 for US Guidance With Paravertebral Facet Joint Nerve Destruction
Question: Our physician used ultrasound guidance during destruction of paravertebral fac... Read more
You Be the Coder:
Anesthesia During Kyphoplasty
Question: Our providers offer kyphoplasty in the office setting. One physician performs ... Read more
CCI 19.2:
Get the Lowdown on the Latest Coding Edits
Changes will affect pain management providers more than anesthesiologists. A new roun... Read more
Documentation:
Follow 6 Tips to Unlisted Procedure Claims Success
Keep encounter explanations simple, but thorough. Filing for “unlisted” p... Read more
Auditing:
Watch 'Hot Buttons' to Improve Your Chances of HIPAA Audit Success
Experts say HIPAA auditors focus on these key areas. HIPAA audit protocols are an inva... Read more
ICD-10:
Barrett's Esophagus Will Expand Diagnosis Choices Under ICD-10
Your provider will need better documentation, or you’ll need access to surgical no... Read more
Reader Question:
Report 349.2 for Lumbar Epidural Fibrosis Diagnosis
Question: What is the ICD 9 code for lumbar epidural fibrosis? Massachusetts Subscri... Read more
Reader Question:
Be Clear on 'Emergency' Before Submitting 31500
Question: A patient was taken to the OR for an “elective emergent intubation&rdquo... Read more
Reader Question:
64450 Applies to Post-Op Digital Block
Question: Our physician performed a digital nerve block on the patient’s right ind... Read more
Reader Question:
Max Out With 2 Units of 80154
Question: Can we bill multiple units of 80154? If so, what is the maximum allowed? ... Read more
You Be the Coder:
Repeat Service Vs. Separate Encounter
Question: Our CRNA administered anesthesia on the same patient on the same day, with a g... Read more
Qualifying Circumstances:
Get a Good Grasp on 'Emergency' Before Submitting +99140
Teach providers that payment for 2 more units depends on their documentation. Coder a... Read more
Epidural Management:
Know Your Anatomy to Better Understand Spinal Epidurals
Tip: Diagnosis can point you to the correct epidural code. One of the most important ... Read more
ICD-10:
Break Down Bimalleolar Ankle Fracture Cases to Uncover These Details
‘Open’ or ‘closed’ won’t be good enough documentation unde... Read more
Reader Question:
Including Radiologist's Diagnoses During Moderate Sedation Is Permitted
Question: I have several questions about when our anesthesiologist provides moderate sed... Read more
Reader Question:
Here's the Lowdown on Field Avoidance
Question: One of our new physicians checked “field avoidance” on the superbi... Read more
Reader Question:
Choose the Best Guidance Code Based On Interlaminar Target
Question: Do payers allow you to report fluoroscopy in conjunction with an interlam... Read more
Reader Question:
Don't Look at 20605 for Trigger Points
Question: The physician administered trigger point injections to fingers 2-5 on both the... Read more
Reader Question:
Focus on 6 Big-Picture Differences Between ICD-9 and ICD-10
Question: I’ve seen so much information about transitioning to ICD-10 that I&rsquo... Read more
You Be the Coder:
Get Clear on CRNA Code Choices for Colonoscopy
Question: Can a certified registered nurse anesthetist (CRNA) bill Medicare for anesthes... Read more
Post-Op Services:
Know When You're Justified in Reporting Post-Op Brachial Plexus Blocks
These 3 tips will keep your claims on track every time. When you see documentation of ... Read more
ICD-10:
Watch for Straight Crossover for Intracranial and Intraspinal Abscesses
Diagnosis code choice will remain simple in 2014. When your anesthesia provider is inv... Read more
Practice Management:
Hiring a Coder? Follow These 8 Steps to a Successful Search
Our guide will help you find the best candidate for your practice. Hiring a coder is ... Read more
Reader Question:
Rib Surgery Code 21810 Crosses to 00472
Question:  I’m coding for anesthesia during rib plating surgery. The surgeon ... Read more
Reader Question:
Hernia Repair for 9-Month-Old Leads to 00834
Question: Our anesthesiologist provided services for a 9-month old normal child who unde... Read more
Reader Question:
Be Aware of Column 2 Edits for 64450 With 77002
Question: I have looked, but cannot find information regarding whether you can bill 6445... Read more
Reader Question:
Understand Full Meaning of Modifier 53 to Choose Appropriately
Question: Our pain management specialist was in the midst of administering a trigeminal ... Read more
Reader Question:
Know Interlaminar Block Target Before Selecting Your Fluoro Code
Question: Do payers allow you to report fluoroscopy in conjunction with an interlaminar ... Read more
You Be the Coder:
Tracing 'Invalid Modifier' Denial With 01996
Question: Several of our payers (private and Medicare) are denying claims with 01996 due... Read more
CCI 19.1:
Steer Clear of Reporting Epidurals with 200+ Procedures -- Sometimes
Latest coding edits change modifiers for hundreds of pairs. The latest Correct Coding... Read more
Documentation Strategies:
Answer These Anatomy Questions to Determine the Best Codes
Knowing small details can make a big difference in your claims. Because CPT® anes... Read more
Practice Management:
Check Out How Practice Management Software Eases Your Administrative Tasks
Tip: Know which features will count the most for your group. Medical practice manageme... Read more
ICD-10:
Prepare for New Vessel Terminology in ICD-10
New I82.4- family gets specific for thrombosis. Right now, knowing whether a lower ex... Read more
Reader Question:
Clear Documentation Helps You Report Both GA and Epidural
Question: The patient had video-assisted thoracic surgery (VATS) and middle lobe lobecto... Read more
Reader Question:
Use 'Other' Code 64450 for Saphenous Nerve Block
Question:  The physician administered a sciatic nerve block to the thigh and a saph... Read more
Reader Question:
Payer Will Guide Modifier Choice for 2 Anesthesia Encounters on Same DOS
Question: A patient had two different types of anesthesia administered on the same day, ... Read more
Reader Question:
Unsupervised CRNA Claims Need Modifier QZ, Not AD
Question: Our gastroenterology office uses contracted CRNAs to provide anesthesia to our... Read more
Reader Question:
Look to 0230T, Not 64483, for Ultrasound Guidance
Question: The physician documented that he administered transforaminal epidurals to... Read more
You Be the Coder:
Reporting Modifiers With +99100
Question: We’ve been having trouble with claims including 99100. What is the corre... Read more
Techniques:
Understand When TIVA Means MAC -- or General Anesthesia
Hint: Pay attention to how anesthesia is administered. Many anesthesia coders are accu... Read more
ICD-10:
Start Watching Shoulders for Non-Traumatic Rotator Cuff Tears
You’ll need that extra ‘location’ detail for ICD-10 coding. When you... Read more
Collections:
Watch These 4 Areas to Recoup Justified Reimbursement
Tip: Don’t delay follow up if you want to keep reimbursement flowing. Leaving no... Read more
Reader Question:
Report J3301 for Either Generic or Brand Name Version
Question: My doctor is using Kenalog 40 (NDC 0003029328) from Bristol Meyers Squibb. He ... Read more
Reader Question:
Post-Op Block Can Take Place Before Surgery
Question: Our anesthesiologist’s notes documented: Axillary nerve block w/ultra... Read more
Reader Question:
Epidural Catheter Implantation
Question: The physician performed an epidural catheter implantation under moderate sedat... Read more
Reader Question:
Don't Focus on PFS for Anesthesia Payments
Question: We’re receiving denials from one payer that says Medicare doesn’t ... Read more
Reader Question:
Cross Code for 15823 Is 00103, Not 00140
Question: We billed 00140 with modifiers QS, LT, and 3.5 units. Medicare said the modifi... Read more
Reader Question:
Watch Times Before Reporting 99144
Question: How should I bill 99144? I have been getting denied for "Invalid unit/bas... Read more
You Be the Coder:
Reporting Anesthesia for Colonoscopy
Question: I bill the anesthesia for a GI physician, and lately he’s been asking us... Read more
Quality Measures:
Get the Lowdown on Reporting Perioperative Temperature Management
If you don’t have documentation of criteria, turn to special modifiers. Periope... Read more
ICD-10:
Pneumothorax Codes Will Offer Better Choices in 2014
There’ll be no more need for ‘unspecified’ diagnoses. Several treatm... Read more
Auditing:
Prepare Now for 5 Audit 'Hot Spots' Your Practice May Face
Understanding several types of audits can help your practice prepare. Auditors from mu... Read more
Clip and Save:
Follow These Tips to a Successful Self-Audit
Good news: Clean claims might be closer than you think. Self-audits are not only neces... Read more
Reader Question:
Watch 2 Factors for Correct 80101 Reporting
Question: Our group recently added a pain management specialist. She performs random dru... Read more
Reader Question:
GI Anesthesia Might Be Allowed in New York
Question: Several of my New York clients have told me that Medicare in New York will no ... Read more
Reader Question:
Double Check Details Before Billing Unused Labor Epidural
Question:  An obstetrician requested that our anesthesiologist place a labor epidur... Read more
Reader Question:
Look to G8644 For 'No License' Exceptions
Question: Should we report G8644 when a provider doesn’t have authority under fede... Read more
You Be the Coder:
Choosing Whether 99221 or 99231 Is Better Fit
Question: Our anesthesiologist was consulted for a possible emergency intubation. When h... Read more
CCI Edits:
Say Good-Bye to Reporting Anesthesia With Needle EMGs
Plus: Pay close attention to modifier indicators in CCI 19.0. The first round of Corre... Read more
ICD 10:
Follow These 4 Steps to Fix Neck of Femur Fracture Coding
Top tip: Teach providers to document side and type to avoid ‘unspecified’. ... Read more
Compliance:
Verify That Your ERX System Meets Requirements, and Earn Extra Pay
Good news: It’s not too late to avoid further pay hits in 2014. Whether your pra... Read more
Reader Question:
Consider Moderate Sedation Options for PO Anesthesia
Question: Our provider administers epidural steroid injections and pain pump trials in h... Read more
Reader Question:
Few Details for Venous Insufficiency Lead to 459.81
Question: A CRNA performed an IV insertion on a patient who was in the GI lab. The reaso... Read more
Reader Question:
Time, Other Documentation Support Using 99149
Question: What is the correct way to bill for CPT® code 99149? Do insurance companie... Read more
Reader Question:
Only Submit 20552 and 20610 Together if Separate Locations
Question: The representative with one of our insurance companies says that 20552 is bund... Read more
You Be the Coder:
Easily Handle Multiple Placements for 01967
Question: I’m coding for a case where the patient was given two labor epidurals wi... Read more
AMA Symposium:
Get the Scoop on CPT Changes for 2013, Straight from the AMA
Tip: Be especially watchful of your chemodenervaton coding. If no one from your pra... Read more
Modifiers:
Simplify Your P Modifier Usage With These Examples
Know how many extra units you can claim for each situation. Although not every payer w... Read more
Clip and Save:
Follow This 9-Question Checklist to Simplify Self-Audits
Hint: It all hinges on the documentation. Even if the OIG hasn’t targeted your ... Read more
ICD-10:
Prepare for Congenital Heart Defect Diagnosis Change to Q25.0
Tip: Remember to include ‘personal history’ diagnosis. Once ICD-10 goes in... Read more
Reader Question:
Focus on Reason for Procedure When Choosing a Diagnosis
Question: Should the ICD-9 placed on the 1500 claim form be related to the procedure its... Read more
Reader Question:
Surgical Site Determines 'Upper' or 'Lower' Abdomen Anesthesia
Question: Can you provide an example for knowing which area is upper abdominal and which... Read more
Reader Question:
Start Counting Time at Induction, Not During Interview
Question: We’re having quite a discussion with our physicians regarding stop and s... Read more
Reader Question:
You Can Collect Co-Pays, But Educate Patients First
Question: One of our providers returned from a meeting, saying he had talked to other pr... Read more
Reader Question:
Until ICD-10, Go With 'Unspecified' Appendix Code
Question: Our physician provided anesthesia during a procedure to remove the patient&rsq... Read more
Reader Question:
Check Notes for Bilateral Documentation Before Coding
Question: One of our physicians submitted charges for 64483-50 with the following docume... Read more
Reader Question:
Beware of Reporting 64421 Multiple Times
Question: Our pain management specialist administered intercostal blocks at T8, T9, T10,... Read more
You Be the Coder:
Coding for Follow-Up CABG Anesthesia
Question: A patient underwent CABG one day, and it was reopened the next. The same anest... Read more
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