Anesthesia Coding Alert

Reader Question:

Select Separate Codes for Separate Puncture, Chemo Admin

Question: Our anesthesiologist worked with the oncologist on a case involving a lumbar puncture and intrathecal chemotherapy. The anesthesiologist completed the lumbar puncture and the oncologist completed the chemotherapy administration. Code 96450 includes both services, so we tried filing with modifier 80 and modifier 62. The payer denied everything. How should we report the procedure for both physicians?North Carolina Subscriber Answer: Does the documentation indicate why the bundled service was provided separately by the anesthesiologist and whether the lumbar puncture was for a diagnostic or therapeutic purpose? The Correct Coding Initiative bundles these services, but will allow a modifier to explain special circumstances; however, modifiers 62 and 80 are not allowed to be reported with these services. If it was medically necessary to separate the service, your best option may be to report the lumbar puncture with a 59 modifier and documentation to support the separation of bundled services.The oncologist [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Anesthesia Coding Alert

View All