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Anesthesia Coding Alert

You Be the Coder:

Deciding Between 00560, 00563 for Hypothermia

Published on Mon Apr 17, 2006

Question: Our physician provided anesthesia during a patient’s mitral valve repair. What code should I report, considering he also checked “hypothermia” on the chart?


Massachusetts Subscriber


Answer: CPT includes several codes for anesthesia during heart procedures, but only one mentions hypothermia (00563, Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest).
Physicians use the pump oxygenator for many mitral valve cases. Because of this--and because inducing hypothermia without the bypass pump is highly unlikely (the bypass machine can induce and reverse hypothermia)--00563 is probably your correct code instead of 00560 (… without pump oxygenator).

Be sure to verify whether the anesthesiologist used the pump oxygenator before submitting your claim.
 
If you learn that 00560 is the more appropriate code, do not report the hypothermia separately. CPT considers hypothermia to be part of the procedure, even if the descriptor does not mention it.
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