Anesthesia Coding Alert

Question: What services are bundled into anesthesia and not separately billable?

Oregon Subscriber

Answer: According to the Relative Value Book, published by the American Society of Anesthesiologists, the base unit value includes work and resources normally included with the administration of anesthesia. The services listed below are included in the base unit value and not separately billable:

1. Preoperative evaluation
2. Preparation for anesthesia
3. Induction of anesthesia
4. Intraoperative monitoring
5. Maintenance of anesthesia
6. Fluid and blood administration
7. Postoperative evaluation

Some services may be separately billable if not performed during any of the above services. These items could include arterial line placements, central venous catheter placements, pulmonary artery catheterizations, postoperative pain blocks (only if the block is not part of the primary anesthesia plan and is used for postoperative pain), transesophageal echocardiography, and ultrasound guidance for postoperative blocks or lines. These items must be clearly documented and medically necessary to be billed separately. Always check payer policies before billing any add-on services.

Julie McDaniel, MHA, CPC, CANPC, Contributing Writer