Anesthesia Coding Alert

Question: Our anesthesiologist spent 30 minutes using an IV administration of Lidocaine, Deprovan and Anectine to cure a patient of intractable hiccoughs. How should I bill Medicare for this?

Utah Subscriber

Answer: Your best coding option for the case is 01999 (Unlisted anesthesia procedure[s]). Include supporting documentation and determine whether you should also append modifier -GZ (Item or service expected to be denied as not reasonable and necessary). Next, check the associated diagnoses. The general diagnosis of 786.8 (Hiccough) might not support medical necessity for this procedure, so check whether other diagnosis codes apply that might help justify the anesthesiologist's presence.

Don't report the time associated with the procedure, because you're reporting a surgical procedure instead of anesthesia. Also verify whether the hospital supplied the medications; they usually do, which means you should not bill for them.