Anesthesia Coding Alert

Question: Does general anesthesia during procedures require intubation? If so, how is it coded? Ohio Subscriber Answer: According to the ASA's Web site, "general anesthesia" is when the patient has lost consciousness (due to drugs) and cannot be aroused. The capability of keeping the airway open to maintain ventilation function is impaired in many cases, and positive pressure ventilation management may be necessary. Spontaneous ventilation and/or neuromuscular function may be decreased to the point where the patient needs assistance, and his or her cardiovascular system may be affected.

Intubation may or may not be necessary, depending on the patient, medications administered, length of surgery and anesthesiologist. If intubation is necessary during a case using general anesthesia, it is considered part of the case and is not separately billable. However, if the patient has respiratory distress or failure and the anesthesiologist is called to intubate the patient, the service is billable because it is separate from the anesthesia. In that case, use 31500, Intubation, endotracheal, emergency procedure.