Advanced Search

Gastroenterology Coding Alert

Reader Questions:

Co-existing Med Condition Is a Requirement for Anesthesia Service

Published on Tue Sep 21, 2010

Question: When I coded 00810 for anesthesia service during an esophagogastroduodenoscopy (EGD), my claim got denied. The physician's note said the request was due to the patient's symptoms, but no other details were provided. What did I do wrong?South Carolina SubscriberAnswer: For one, you could look into your coding for the patient's condition. Your diagnosis code should indicate the coexisting medical condition that justifies an anesthesiologist's involvement in the case, not the gastrointestinal condition leading to the endoscopy.You could verify with the anesthesiologist if the patient had any of the following condition:a) history of or anticipated intolerance to standard sedatives; or b) Increased risk for complication due to severe comorbidity (American Society of Anesthesiologists [ASA] class III physical status or greater. See Appendix for physical status classifications which can be found in the CPT manual.)c) Patient of extreme age, under one year or over 70; ord) Pregnancy; ore) History of [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Gastroenterology Coding Alert

View All