Anesthesia coding

bizmatics

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Hello, Anesthesia Question - code 01992 Prone position is an additional code or inclusive with other spine code 01936

the base unit for both the codes are same (Base unit 5)
 
Hi bizmatics,
You have not provided enough information to answer your question completely; were both procedures performed during same operative session? Was one a return to the OR? If both were procedures were performed during same operative you would code the procedure with the highest base value units with combined time for all procedures performed during this time period.
Thanks for listening; if you have additional details please provide for clarification.
Dana Chock, RHIT, CPC, CANPC, CHONC, CPMA, CPB
Coding Analyst (May 2018-present), Anesthesia coder (April 2013-May 2018), Pathology & Laboratory Coder (Fall 2012 to May 2018)
 
Hello, so the two things that we have to look at here are simply what the code descriptions say next to each ASA/CPT code. I agree with Dana above in the sense we don't have a copy of the Anesthesia Record to correctly ascertain how to code the case, however I will instruct you to select the code based on what procedure was performed and by which physician performed the procedure and the induction itself. Both codes detail general anesthesia for a spine procedure, however 01992-Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position
I would only report 01992 if the documentation supports that the injection was for diagnostic therapeutic NERVE BLOCK by ANOTHER PHYSICIAN or qualified healthcare professional.
Whereas code 01936-Anesthesia for percutaneous image guided procedures on the spine and spinal cord; therapeutic
Is pretty clear on when and why you would report this anesthesia service (if of course it is the Anesthesia code with the highest base unit rendered, your correct both of these codes have a base unit of 5)
However the distinction here is that 01936 clearly states it is for therapeutic and not diagnostic percutaneous image guided spine or spinal cord interventions. Which cover the full spectrum of those pain and Spine interventions. So it comes down to what procedure was rendered by who, for what purpose and what approach, method and modality were utilized so you can select the correct code. So to answer your question no 01992 is not an additional component to 01936. I would select one or the other based on what procedure(s) were done and for what purpose. You can easily rule out 01936 if the procedure was for diagnostic and not therapeutic purposes. 01992 can be ruled put a multitude of ways being that it must have been a block performed by a different doctor or healthcare professional. For definitive answer and detailed rationale please reply to this with your op note and Anesthesia record without PHI.
You can always email or call me directly with any coding questions. Especially Anesthesia, Interventional Radiology/Cardiovascular, Vascular& Endovascular, Cardiovascular-thoracic surgery, E/M, , Neurosurgery, Orthopedic, Podiatry, Diagnostic Radiology, OB/GYN.
Erik Brown, CIRCC, CPC
Evolve Medical/ Lumed Medical Group
Interventional Radiology/Cardiovascular/ Endovascular Coding and Auditing Director.
Email:Erikbrown619@yahoo.com
801-530-9586
 
Hi Erik,

I have a question. As an Anesthesia Coder, I do not always have access to any other record than the Anesthesiologists documentation. My question here is, if I only know say the procedure being performed and not if it is therapeutic or diagnostic, how would I know which code to select say for a TFESI, 64483 or a MBB, 64493? In 2017, 64483 would crosswalk to 01935 and 01936 but the crosswalk has changed since 2018. I am not sure as to why it changed. Do you have literature or know where I can find this information out? Both of these are image guided and are percutaneous and seems they would meet the criteria for 01935 or 01936 but 01991 or 01992 is used for diagnostic or therapeutic injection (depending on the position) performed by a different physician or qualified health care professional. I assume "other" means not the physician performing the actual injection. I am looking for more clarity on utilizing these Anesthesia CPT codes.
Thank you in Advance for your help!
-- Valerie
 
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