Wiki Anesthesia Codes for colon, egd

[lisner1204]

We are planning on having a CRNA to administer MAC anesthesia for IN office colonoscopies and EGDs. Yes. This is new in the GI world. Not an ASC...IN office suite for endoscopies. Would someone guide me through which codes would be used? Thanks.

 

[mcnaryk]

We are planning on having a CRNA to administer MAC anesthesia for IN office colonoscopies and EGDs. Yes. This is new in the GI world. Not an ASC...IN office suite for endoscopies. Would someone guide me through which codes would be used? Thanks.

I have never billed these procedures in office, only ASC setting. The colonoscopy and EGD codes themselves INCLUDE moderate sedation, so if your office is having a CRNA come in to administer MAC, I would think your doctor needs to bill his services with a 52 modifier since he is not performing the included sedation himself (but I could be wrong??). Then the CRNA would bill 00810 or 00740-both carry a base unit of 3 so if done at the same time, you would just bill one of these anesthesia codes (I usually use the one that has the best supporting diagnosis) and capture the credit for both procedures in the total time reported. Moderate sedation codes 99143-99150 do NOT include MAC per CPT. I am curious if I am on the right track here...does anyone else have experience with billing these in office?

 

[aaron.lucas]

I dont have experience with the colonoscopies themselves, but along with -52 (if it's needed) you should also use modifier -23, as MAC would typically not be used for this type of procedure, so unusual anesthesia should apply. also on the anesthesia code itself one of the CRNA modifiers should be used, QX if directed by a physician, QZ if the CRNA is doing all the work themselves.

 

[jayne]

base units

actually, 00810 and 00740 both have a base unit of 5, not 3. and you should not have to use the -23 modifier.