Anesthesia Coding Alert

Note: These code changes and additions are not yet finalized. The AMA CPT Advisory Committee will meet Nov. 14-15 to review the code changes and make its final determination on new codes for 2003. Once again, the anesthesia section of CPT Codes has major changes in store for 2003. The newest version of CPT, scheduled for release this month, has 10 new codes, 16 revisions and one deletion in the anesthesia section.

"We need coding changes every year to help us further specify the surgical procedures and risks involved in providing anesthesia," says Jann Lienhard, CPC, a consultant with Solutions for Management in Plymouth Meeting, Pa. "Codes were so general in the past that indicating differences between major and minor procedures and getting appropriate reimbursement were difficult because they were coded the same." But this year's CPT Updates take steps toward remedying that situation. CPT 2003 is effective Jan. 1, 2003, although CMS and private carriers have until March 31, 2003, to implement the new codes. But Lienhard cautions that not all payers adopt changes uniformly (and some commercial and workers' compensation carriers still require surgical instead of anesthesia codes), so it's important to check with your local Medicare and private carriers before using any of the revised codes. New Anesthesia Codes Fill Reporting Gaps Many of the new anesthesia codes for 2003 correspond to existing codes and make reporting of services even more specific. New codes include:
  00326 Anesthesia for all procedures on the larynx and trachea in children less than 1 year of age (Do not report 00326 in conjunction with code 99100). This code (and several other new ones) will be especially helpful to coders in children's hospitals or whose practices treat many children. In the past, code 99100 (Anesthesia for patient of extreme age, under one year and over seventy [list separately in addition to code for primary anesthesia procedure]) would often be billed in addition to the procedure code for a patient this young. But you can no longer do that since the new code incorporates the risk of caring for a young child in the code's base value. 00539 Anesthesia for tracheobronchial reconstruction 00541 Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including thoracoscopy); utilizing one-lung ventilation. This is a welcome addition to anesthesia coding as one-lung ventilation becomes a more common procedure. "One-lung ventilation often requires more work by the anesthesiologist," says Albany, N.Y., anesthesiologist Scott Groudine, MD. "This CPT change acknowledges the increased mental and physical work that often accompanies one-lung ventilation." This increased difficulty is evidenced by a base value of 15, where associated code 00540 (Anesthesia for thoracotomy procedures involving lungs, [...]