Anesthesia Coding Alert

Question: The practice I recently began working with bills for anesthesia services during gastro procedures, such as when a patient has a colonoscopy or EGD. They think it is necessary to bill for all non-procedure diagnoses (diabetes, hypertension, obesity, etc.). I don’t think these diagnoses should be added to the claim because they have nothing to do with the procedure performed. What’s your advice?

Nebraska Subscriber

Answer: Their tendency to bill for additional diagnosis codes could be due to payer requirements of LCD guidelines. For example, depending on the type of anesthesia technique used, the payer might require documentation of a secondary diagnosis to support the need for anesthesia (such as a higher level of anesthesia versus moderate sedation).

Discuss any concerns with your supervisor or the lead billing specialist. He or she should be able to explain their reasoning.