Anesthesia Coding Alert

Question: Several pain management procedures our physicians perform are not included in our Anesthesia Cross Coder. Which anesthesia codes should I report for these procedures? I especially need help with therapeutic injections 62291, 62310, 62311, 64470, 64479, 64483 and 64510, and radiofrequency lesioning (64626).

Virginia Subscriber
 
Answer: The first question you need to answer is whether you're coding for a physician to perform the procedure or for a physician to provide anesthesia during the procedure.
 
If you're reporting the procedure itself, bill the surgical code as a flat-fee service instead of an anesthesia code with base and time units (such as 64470-64476 for various levels of Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve ...).
 
Two physicians must be present during these procedures before you can charge anesthesia for them. You'll bill the surgical code for the physician administering the injection and will cross it to the appropriate anesthesia code for the second physician.
 
Procedure 62291 (Injection procedure for diskography, each level; cervical or thoracic) crosses to anesthesia code 01905 (Anesthesia for myelography, diskography, vertebroplasty).
 
Single epidural injections 62310 and 62311, and 64510 (Injection, anesthetic agent; stellate ganglion [cervical sympathetic]) cross to 01991 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; other than the prone position).
 
Procedures 64470 (Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; cervical or thoracic, single level), 64479 (Injection, anesthetic agent and/or steroid, transforaminal epidural; cervical or thoracic, single level) and 64483 (... lumbar or sacral, single level) cross to anesthesia code 01992 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; prone position).
 
Most carriers do not pay for anesthesia during some of the procedures you mention. Verify that you have documentation of medical necessity for the anesthesia before billing for it.