Anesthesia Coding Alert

Question: We understand billing for anesthesia in conjunction with a paraspinal nerve injection is typically not required. However, if we do need to bill for anesthesia in one of these cases, how do we handle it? And what if the provider used either an epidurogram or fluoroscopic guidance when doing the block? Would you then use 01935 or 01936?

California Subscriber

Answer: If an anesthesiologist or CRNA provides anesthesia for diagnostic or therapeutic nerve blocks or injections, and a different provider performs the block or injection, then the anesthesiologist or CRNA may report the anesthesia service using 01991 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different physician or other qualified health care professional]; other than the prone position) or 01992 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different physician or other qualified health care professional]; prone position).

Before reporting the case this way, the service must meet the criteria for monitored anesthesia care. If the anesthesiologist or CRNA provides both the anesthesia service and the block or injection, then you report the anesthesia service using the conscious sedation code and the injection or block.

Codes 01935 (Anesthesia for percutaneous image guided procedures on the spine and spinal cord; diagnostic) and 01936 (Anesthesia for percutaneous image guided procedures on the spine and spinal cord; therapeutic) are specifically meant for percutaneous image guided procedures, not nerve blocks. Submit 01935 to report anesthesia for myelography and discography, and 01936 to describe anesthesia for vertebroplasty, kyphoplasty, and chemonucleolysis.