Wiki Anesthesia qualifying circumstance codes

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Bobby A

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Anesthesia coding with use of Qualifying Circumstances. With the use of the qualifying circumstance codes; 99100 for patient over 70, her I am seeing some opinions of if the patient turned 70 yesterday she is over 70. I personally would say she would need to be 71 to use this code (as long as the code description does not state age). What are your thoughts and is there somewhere to go for more black and white description.

Thanks have a great weekend
 
I'm sorry, I don't have an answer for you, but rather a question. Do have much success in getting this code paid? I haven't found any payers in our area that pay this code.
 
Technically, once you're 70 + one day, you're over 70.

The only time we get paid on 99100 is when it's on a claim for a child of the appropriate age.
 
i know this is really old, but has anyone received a payment from a patient that was 70 for 99100? my colleagues are saying patient should be 71 but i agree, 70+1 day is "over 70". I would think the definition would state "71 or over".

thanks!
Amy E.:confused:
 
amyce2693 said:
i know this is really old, but has anyone received a payment from a patient that was 70 for 99100? my colleagues are saying patient should be 71 but i agree, 70+1 day is "over 70". I would think the definition would state "71 or over".

thanks!
Amy E.:confused:
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I would like to know the answer as well, I've read different articles, as similar to the one below:

Question: What guidelines should I follow when reporting 99100 for extreme age?


Answer: You should use +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]) only in certain age-related situations. Report it along with the anesthesia procedure code when your physician works with an infant or an adult older than 70 years of age.

Coders sometimes debate what “older than 70” means; your best rule of thumb is to report 99100 for patients who are 71 years of age or older, not patients in the year following their 70th birthday.
 
I'd go by the past the 70th birthday rule (At least that's whats noted in findacode) . If you read the code description It's "under one year or over 70". If 11 months and 29 days 23 hours old is under one year, then why is 70 years and 1 hour old not over 70? Not that it makes a huge difference since most payers do not pay extra anyways. Have a good justification, you shouldn't have any problems should there be an audit and the auditor has a different interpretation.
 
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