Anesthesia Coding Alert

Question: How should I bill anesthesia for a patient of extreme age, and anesthesia complicated by an emergency condition? Should I add extra units for these circumstances to the procedure's base units, or should I bill them separately? Virginia Subscriber Answer: The correct way to handle this situation depends on the carrier. Some carriers will not pay for the qualifying-circumstances codes unless the units for them are added to the main procedure, but simply adding units to the procedure code can raise red flags with the carrier.

Other carriers want the circumstances listed separately, which helps explain why the physician is requesting additional fees for the service. In your example, you should use +99100 (Anesthesia for patient of extreme age, under one year and over seventy [list separately in addition to code for primary anesthesia procedure]) and +99140 (Anesthesia complicated by emergency conditions [specify] [list separately in addition to code for primary anesthesia procedure]) along with the procedure's anesthesia code. Other carriers, such as Medicare, will not accept the qualifiers, so adding extra units for them does not increase your reimbursement.