Anesthesia Coding Alert

Question: Our anesthesiologist sometimes performs anesthesia for a pain management physician. In a recent procedure, the pain management specialist performed 64626 (Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level) and +64627 (... cervical or thoracic, each additional level [List separately in addition to code for primary procedure]). How should I code our anesthesiologist's involvement?

North Dakota Subscriber

Answer: The anesthesia codes correspond to the patient's position at the time of the injection, so knowing his or her position will lead you to the correct code:

• If the patient was placed on his stomach or in the prone position during the procedure, report 01992 (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; prone position).

• If he was in any other position the position was other than prone -- that is, sitting up or lying on his back or side -- use 01991 (... other than the prone position).

Don't forget: CPT states that you cannot report 01991 or 01992 with 99143- +99150 (Moderate sedation services ...).