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Anesthesia Coding Alert

Reader Question:

Medicares MAC Policy

Published on Wed Dec 01, 1999

Question: There are several ASA codes in the Relative Value Guide that are not in CPT- 4, such as 01951 and 01952 (defined in the previous question) for MAC during nerve blocks. Does Medicare/HCFA state in its policy which code book it uses? If so, where can I obtain a copy of the policy?

Gerry Malloy, Practice Administrator,
Lehigh Anesthesia Associates, Allentown, Pa.

Answer: The two codes you give as examples are not recognized by Medicare and are not on its fee schedule. If you send in a claim with either of these codes (or others that are not on the fee schedule), Medicare will deny it, according to its customer service department. Your best chance for being reimbursed in this situation is to call your local Medicare representative and ask for their most recent fee schedule so you can file the claim with the Medicare code that best matches the procedure.

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