Anesthesia Coding Alert

Question: Do most carriers reimburse for position codes CPT 01991 and CPT 01992 ? Our physicians might begin providing anesthesia for procedures that warrant these codes. Our local Medicare carrier hasn't published a  policy regarding this, so I'm interested in how commercial carriers reimburse these services.

South Carolina SubscriberAnswer: Your success in using these codes will depend on the carrier. Most carriers seem to recognize these codes and reimburse the additional units for them. Code 01991 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; other than the prone position) is 3 base units plus time; 01992 (... prone position) is 5 base units plus time.

Some coders say they have problems with reporting these codes to certain carriers. You might begin to get paid if you send a letter stating that these are valid CPT Codes. If that doesn't work, resubmit your claim with 00300 (Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified) or 00400 (Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified), depending on the patient's position.

Workers' compensation in your state may or may not recognize 01991 and 01992, depending on the edition of CPT that they follow. Florida, for example, uses either CPT 2001 or 2002 and therefore does not accept either code.

Report the second anesthesiologist's services with the appropriate anesthesia code for the treated area (00600, Anesthesia for procedures on cervical spine and cord; not otherwise specified; 00620, Anesthesia for procedures on thoracic spine and cord; not otherwise specified; or 00630, Anesthesia for procedures in lumbar region; not otherwise specified).