Find Codes for Anesthesia Servies During Bypass Surgery
Question: One of the anesthesiologists I work with began a cardiopulmonary bypass case without the pump oxygenator and completed one arterial graft. Then they switched to on-pump to complete additional grafts. What is the correct way to code this? AAPC Forum Participant Answer: Heart procedures can be complex, and while it is hard to accurately code without being able to review the records, we can apply some general knowledge to this question. If cardiopulmonary bypass is used for any portion of the procedure, then it is considered an on-pump procedure, which you should report with 00567 (Anesthesia for direct coronary artery bypass grafting; with pump oxygenator). Please note the Relative Value Guide (RVG) comment under this code, and if the procedure involves both coronary and valve work, then report 00562 (Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation). Remember to also bill any codes that are documented but not included in the base value, such as arterial lines, central venous lines, and pulmonary artery catheters. As always, make sure you are accurately reviewing the anesthesia record and operative reports — as well as specific payer policies — to ensure accurate coding. Julie McDaniel, MHA, CPC, CANPC
