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Anesthesia Coding Alert

Reader Question:

Separate 64417 and 01810 Depends on Documented Purpose

Published on Mon Jun 11, 2012

Question: How would you code this case that included discontinuous time?  Provider: AnesthesiologistPayer: Medicare Surgery: Carpal Tunnel Syndrome ASA Time: 10:47-11:20Axillary Nerve Block /w stim. time: 09:45-10:05Type of Anesthesia Checked:  TIVA, Regional, MACTennessee Subscriber Answer: You may not have a case of discontinuous time as much as a case of two different anesthetics being administered. Begin by verifying whether the axillary block was part of the anesthetic, or used for postoperative pain management after the surgery. Option 1: If the anesthesiologist placed the block for post-op management, report it with 64417 (Injection, anesthetic agent; axillary nerve), without time. Although there is documentation to support 20 minutes of time, time is not reported separately or applicable to this procedure code. Append modifier 59 (Distinct procedural service) and include diagnosis code 338.18 (Other acute postoperative pain). Also report 01810 (Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, [...]
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