Anesthesia Coding Alert

READER QUESTIONS:

CABG Calls for 00567

Question: I have a patient who had a coronary artery bypass graft (CABG) (x2) and also transmyocardial revascularization (TMR). My physician wants to use 00562 due to doing the TMR as well. Do I use 00562 or 00567 and why?

New Hampshire Subscriber

Answer: TMR is a separate procedure from a CABG.Generally, ASA code 00562 (Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures [e.g., valve procedures] or for re-operation for coronary bypass more than 1 month after original operation) better describes a TMR. Because you should bill for the highest-based procedure -- in this case,the TMR, whose code contains 20 units -- bill 00562.Code 00567 has 18 base units.

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