Anesthesia Coding Alert
Remember That Procedure Code Includes Cardiopulmonary Monitoring
Question: Our anesthesiologist used blood pressure monitoring, pulse oximetry, and ran a rhythm strip during a trigger point injection with ultrasound guidance (the injection was administered by a different provider). Can we bill for all of those monitoring services? West Virginia Subscriber Answer: Many procedures (such as those you mention) require that either the physician performing the procedure or an anesthesia provider offer cardiopulmonary monitoring. Because these services are integral to the procedure, you should not report them separately. The National Correct Coding Initiative (NCCI) policy manual shares several examples of these services, such as cardiac monitoring, pulse oximetry, and ventilation management (e.g., 93000-93010, 93040-93042, 94760, and 94761). Because of this, in the scenario you describe the provider who performed the procedure can only bill for the injection itself with 20552 (Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)) and ultrasound guidance with 76942 (Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation).
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