Anesthesia Coding Alert

CPT Codes 2003 is coming out next month, but some coders are still trying to understand changes made to the 2002 book. One such area is the section of anesthesia codes for radiological procedures. With eight new codes, eight deletions, and two revisions to the subsection, it's understandable that correctly applying them has presented challenges.

"There have been many advances during the past few years related to interventional radiology (IR) procedures," says Cecelia McWhorter, BA, CPC, a coder with the physician billing agency Comp One Services in Oklahoma City. "Many physicians are performing new procedures such as placement of shunts, coils, filters and stents that will prevent further complications for the patient."

And since an anesthesiologist may be present during these types of procedures, the anesthesia codes needed to be updated to keep up with the changes in this area of medicine. When Is Anesthesia Being Used? Tonia Raley, CPC, claims processing team leader with the medical billing firm Medical Information Management Systems in Tuscon, Ariz., has seen an increase in the number of interventional radiology cases that her physicians are providing anesthesia for. "We're providing anesthesia services for procedures such as abdominal aortic aneurysm (AAA), transjugular intrahepatic portosystemic shunt (TIPS), and intracranial transcatheter occlusion or embolization."

Raley and McWhorter give these examples of the types of IR procedures that sometimes correspond to the anesthesia codes for radiology procedures:
  01905 (Anesthesia for myelography, diskography, vertebroplasty) - This code is somewhat self-explanatory. It is used to report anesthesia during procedures such as 70010 (Myelography, posterior fossa, radiological supervision and interpretation). 01916 (Anesthesia for diagnostic arteriography/venography) - Anesthesia is rarely required for arteriography unless you are treating a child or a profoundly ill or mentally impaired adult. It could be used for procedures such as 36000* (Introduction of needle or intracatheter, vein). 01920 (Anesthesia for cardiac catheterization including coronary angiography and ventriculography [not to include Swan-Ganz catheter]) - This code could correlate to code 36013 (Introduction of catheter, right heart or main pulmonaryartery), but anesthesia is used for these cases in rare circumstances, such as with code 01916. 01922 (Anesthesia for non-invasive imaging or radiation therapy) - Patients undergoing these procedures may need anesthesia because remaining still may be important; the patient does not need to move when high-level radiation treatment is provided. Code 01922 is used when children receive radiation therapy for cancer, for adults who are unable to remain still because of movement disorders (such as severe Parkinson's disease), or for procedures such as 70030 (Radiologic examination, eye, for detection of foreign body). 01924 (Anesthesia for therapeutic interventional radiologic procedures involving the arterial system; not otherwise specified) - This is for [...]