Wiki Anesthesia Question about add-on codes


Millstadt, IL
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I am hoping someone can help me with Anesthesia billing. I am new to Anesthesia, but have done Surgery Billing for years.

When I review pages Vii and Viii in the 2017 Crosswalk/American Society of Anesthesiologists it states on page vii- "In general, there is only one anesthesia code for any single CPT code." In addition it states-"Also, when multiple surgical procedures are performed during a single anesthetic administration, only the anesthesia code with the highest base unit value is reported. (The time reported is the combined total for all procedures.) Add-on anesthesia codes are an exception to this policy. They are listed in ADDITION to the code for the primary procedure."

Then on page viii- It has CPT includes three add-on anesthesia codes: +01953, +01968 and +01969.

Are these the only three add-on codes for Anesthesia?

Please advise if I am understanding this correctly, but when you bill AN16030 with an ASA code of 01952 and you need to bill 01953 do to the size. Would it be billed as AN16030 with 01952 and 01953 depending on the size and what is documented? In addition, all of the time reported would be billed under code 01952, correct?

We WOULD NOT enter it as AN16030 with 01952 and then AN16030 with 01953 x how many units, correct?

Lastly, these 3 add-on codes are an exception to the rule where you can bill more than one ASA code for a procedure, correct?

Thank you in advance for any help.
Those 3 codes are the only ASA add on codes

There re a few CPT add on codes 99100, 99116, 99135 & 99140 for special circumstances such as extreme age, use of controlled hypotension or control hypothermia and emergency conditions. Some payers pay more and some don't. Also additional codes for unusual forms of monitoring (like Swan-Ganz, Inter-arterial, central venous)

Most payers wont want the CPT only ASA code.

01952 with the time.
01953 x 1 unit for each additional 9% TBSA (or part there of)

So 30% would be:

01952 w/ Time for the whole procedure
01953 x2 (rounded up due to 28-36% for the part there of)

For the OB ones, i believe you would split the time between the 01967 and 01968/01969
I agree with the above response.

If you have a patient that goes from a vaginal delivery to a C-section it would be billed:

01967 + time for the vaginal attempt

01968 + time for the C-section (make sure you receive the diagnosis for the switch to c/s)

We may bill 01996 the day following a C-section for daily hospital management of the epidural & post-op pain. It must be documented and is not billed with time.