Anesthesia Coding Alert

Keep these guides in mind to help prove your case. With payers tightening the reins on reimbursement, establishing medical necessity for your anesthesiologist's services can be one of your biggest coding challenges. Follow our real-world tips for choosing the best diagnosis to establish the need for anesthesia and help keep your reimbursement intact. Study the Patient's Circumstances Medicare defines "medical necessity" as services or items reasonable or necessary to diagnose or treat an illness or injury, or to improve the functioning of a malformed body member. Payers consider each case individually to determine if the treatment method is reasonable and necessary. Circumstances that help establish medical necessity for anesthesia can include: Medical conditions such as cancer, epilepsy, or seizure disorders. A danger of airway compromise because of sleep apnea. A history of being combative or the onset of diminished ability to comprehend what's happening. The need to establish and maintain [...]