Anesthesia Coding Alert

Question: Our anesthesiologist completed a patient's preoperative assessment before femoral bypass graft surgery under anesthesia. After the procedure, another physician from the anesthesia group consulted with the patient regarding pain control and recommended medications. Since the anesthesia team already saw the patient before and during surgery a few days earlier, how should I report the second consult?

Missouri Subscriber

Answer: Although the anesthesiologist you're coding for hasn't seen the patient previously, another physician in the group has, so you can't code it as an initial inpatient consult. Coders differ in their recommendations on how to handle the case. Some say to report it as subsequent hospital care with the appropriate choice from 99231-99233, depending on the circumstances (various levels of Subsequent hospital care, per day, for the evaluation and management of a patient).

Other coders say the anesthesiologist "consulted" on the patient as part of the normal anesthesia global procedure, so it is not a separately payable item.
  
Correct coding depends on whether the surgeon requested another visit with the patient or if the pain physician initiated the follow-up and additional care. Verify whether the surgeon requested the consult - and be sure all of the appropriate documentation requirements are met - before reporting subsequent care codes 99231-99233.