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Anesthesia Coding Alert

Reader Question:

Anesthesia for Balloon Kyphoplasty

Published on Sat Sep 01, 2001

Question: Medicare will not pay for the anesthesia code that balloon kyphoplasty cross-references to (00640, anesthesia for closed procedures on cervical, lumbar or thoracic spine). Which codes are payable?

Iowa Subscriber
 
Answer: For a lumbar procedure, use 00630 (anesthesia for procedures in lumbar region; not otherwise specified) or 00300 (anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified). Although CPT doesnt explicitly state it, 00630 is primarily intended for open procedures instead of closed and carries a much higher unit value (eight) than 00300 (five). Since balloon kyphoplasty is a closed procedure and the unit value of 00300 is more appropriate to balloon kyphoplasty, it is the best code to use.    -- Answers for You Be the Coder and Reader Questions provided by Tammy Caldwell, an anesthesia coding team leader with the billing and consulting firm North Colorado Professional Services in Fort Collins, Colo.
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