Wiki Coding Help 3rd party payor vs MCR coding

[hstrasko_rn@atlanticlegalnurseconsultants.com]

Hello to all,
Just wanted to get some feedback before I sit again for the CPC exam later this month.

We used to use the Anesthesia coding that starts with: 00100, 00102, 00103, etc strictily for Medicare patients.

The 3rd Party Payors, i.e. Blue Shield, Aetna, Cigna, etc required the Anesthesia coding be done in the regular CPT codes. Meaning, we used the codes starting with 10021, 20005, etc to describe the surgical procedure that anesthesia was given for.

Has this changed at all? I would like to be sure about this. I was just completing some of these questions when time ran out.

Thank you all for your assistance.
H.Strasko

 

[dwaldman]

The 3rd Party Payors, i.e. Blue Shield, Aetna, Cigna, etc required the Anesthesia coding be done in the regular CPT codes. Meaning, we used the codes starting with 10021, 20005, etc to describe the surgical procedure that anesthesia was given for.



With the above statement, if you trying to be reimbursed for anesthesia service why would you report 10021 or 20005 to represent the anesthesia service? Maybe I don't understand what is being said?

 

[eugenia]

anethesia coding vs procedure coding with anethesia

Reminder, you bill the monitored anesthesia procedures according to the "time reporting" instructions at the beginning of the anesthesia section which covers 00100-01999. If you are coding a procedure which includes anesthesia (ie closed treatment of ankle dislocation 27842) and this was not performed with an anesthetist where "time reporting" has been documented but instead the treating physician applied a nerve block (ie 64450) then you would not use codes 00100-01999. You will really have to read the test question carefully to answer correctly to what was performed, where it was performed, and by whom it was performed.

Good luck.

 

[hstrasko_rn@atlanticlegalnurseconsultants.com]

Coding Help 3rd party payor vs Mcr coding

First-thank you for your responses. Your replys are appreciated. When surgery is performed, the surgeon is asked towards the very end of his/her case to give the operation performed for the Anesthesiologists paperwork and the circulating RN's paperwork. The surgical procedure is to match both documents and this is what is to be billed for. For the 3rd Party payors, this is where the anesthesia Dr gets his/her codes from. (Except when billing Medicare patients).