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Anesthesia Coding Alert

Reader Question:

Choose 00142 for Cataract Block, Not 01991

Published on Thu Apr 12, 2012

Question: I have a CRNA who practices solo at a surgery center doing cataract anesthesia for Medicare patients. I have been unable to get Medicare to pay a peribulbar block. I reported 01991 with modifier QZ and Medicare denied my claim for the modifier. I billed again without a modifier and Medicare denied that claim also. How should I report the block? Oklahoma Subscriber Answer: Your CRNA isn't providing anesthesia to place the block, so steer clear of 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). Instead, she is providing anesthesia for the cataract surgery. Report the cataract anesthesia service with 00142 (Anesthesia for procedures on eye; lens surgery) and append modifier QZ (CRNA service: without medical direction by a physician). Your CRNA may be able to bill discontinuous time for the block [...]
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