Wiki Anesthesia Diagnosis

Create Wiki
J

Jdeleon

Guest
Messages
4
Location
Peoria, AZ
Best answers
0
Hello All,
I am just getting back in coding and I have not done Anesthesia in a very long time. I have a general, very simple question. When coding the diagnosis for anesthesia do I place the reason for anesthesia as the first diagnosis pointer? Or would it be on the second diagnosis pointer. This is for a Pain management, and for an ASC.

Thank you :giggle:
 

Attachments

  • Anesth.pdf
    26.7 KB · Views: 17
You would place the reason for the procedure first. In this case, I don't think it would be F41.9 (Anxiety, unspecified), as that would not be a primary reason for pain management treatment.
 
I would just add that depending on the pain procedure and the carrier, you might receive a denial that you'll need to appeal. Medicare and a lot of private payers have adopted policies that treat anesthesia for blocks and RFA of the spine as medically unnecessary unless the documentation convinces them that it was.
 
I agree with Lisa. I am having issues with my carriers and having to attach my LCD's/policy guidelines for my providers to review and make dx corrections. Right now we are dealing with Cigna not paying. If you are having issues with Cigna, I have called and spoke with the 5 different reps (they refused to send me to supervisor/auditor) each gave me almost the same answer....they follow CMS guidelines but also have their own policy #0551. The codes we use after researching further is that they are carve out codes. So basically follow Cigna guidelines. Learned quickly if the reps state they follow CMS but also have their own policy, just follow their policy. (I code the claims but also help out the denials specialist)

Just a quick question for everyone, are you all having issues with United Healthcare commercial plans paying? We are receiving a lot of bogus denials (for anesthesia and pain management procedures). Claims are going out clean and following all insurance guidelines. Could this be a tactic to delay payment? Is there anyway around this? Suggestions, references, etc. would be greatly appreciated.

Thank you,
Whitney
 
You must log in or register to reply here.
Top