Part B Insider (Multispecialty) Coding Alert

Published on Fri Aug 13, 2010 PDF

Question: We use CRNAs in our ambulatory surgery center to provide anesthesia during upper or lower GI endoscopies. Our physician recently saw information on including +99100 for patients over age 70 and J3490 for Propofol during the procedures. Can we submit J3490 for a CRNA, or is there a different code we should report?

Answer: Your physician is correct, in certain circumstances. If a physician performs the procedure, you can add +99100 (Anesthesia for patient of extreme age, younger than 1 year and older than 70 [List separately in addition to code for primary anesthesia procedure]) for patients with insurance other than Medicare or some state Medicaid carriers.

Whether you report J3490 (Unclassified drugs) depends on who supplies the medication. If the ASC supplies the Propofol, neither the doctor nor the CRNA can submit a charge because the ASC will. If your providers offer office-based procedures and supply the Propofol themselves, you can include the J code along with the anesthesia service. In your example, the anesthesia code would be either 00740 (Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum) or 00810 (Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum).