Anesthesia Coding Alert

Question: How should I handle the claim when our physician provided only an overall start/end anesthesia time (60 minutes) for an EGD plus colonoscopy? Do I report both codes and split the time between them?

Alaska Subscriber

Answer: CPT's anesthesia guidelines for separate or multiple procedures indicate that you report the "most complex" procedure; this differs slightly from the American Society of Anesthesiologists' recommendation to bill the "anesthesia code with the highest base unit value." Both resources direct you to report the combined/total time with a single procedure.

Codes 00740 (Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum) and 00810 (Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum) have the same base value of 5. You can submit either code with the total start/stop times; just be sure to include both diagnosis codes.