Anesthesia Coding Alert

Question: Our physician administered anesthesia during a temporary tracheostomy. He also performed a fiberoptic bronchoscopy during the procedure. How should I code the claim?


Nevada Subscriber


Answer: When your anesthesiologist performs more than one service during a procedure, you only report the service with the highest level of base units. The additional time units you’re able to report help reimburse for the additional procedures.
 
In this case, 00320 (Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older) is the tracheostomy code, with six base units.

Verify why the physician performed the fiberoptic bronchoscopy before coding for it. Did he use it as a diagnostic tool, or to assist with the tracheostomy or the intubation? If the fiberoptic bronchoscopy was separate from the anesthesia service, you can code it separately with 31622 (Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; diagnostic, with or without cell washing [separate procedure]). If the fiberoptic bronchoscopy was part of the anesthesia service, you cannot bill it separately.

Note: Remember that you can always code separately for some anesthesia-related services such as arterial line placement (36620, Arterial catheterization or cannulation for sampling, monitoring or transfusion [separate procedure]; percutaneous, or 36625, … cutdown) or Swan-Ganz catheter placement (93503, Insertion and placement of flow-directed catheter [e.g., Swan-Ganz] for monitoring purposes).