Field Avoidance-Can anyone help

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Can anyone help me with billing/coding for field avoidance. Everyone at this facility has a different idea about what it means and when and how to code and bill for it. Where can I find "concrete" information on this topic and/or can someone please advise?
Thanks.
Michelle Constable, CPC
michelle.constable@hrhonline.org
 

mcintireh

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Bucyrus
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We struggle to get payers to consider this but Anthem does have a written policy that describes it however, they don't tell you how to bill for field avoidance. The concrete rules are in the RVG and describe when the minimum base unit should be raised to 5. If you go to the ASA website you can also search for "field avoidance" and get some information on what positions or surgeries are involved. However, all our payers require that we submit a copy of the ASA guidelines describing field avoidance and copies of the op notes and anesthesia records. The claims need to be submitted hardcopy with a 22 modifier in the first modifier field. (Medicare and Medicaid of Ohio do not recognize "field avoidance" or the 22 modifier.) Good luck.
Holly M.
 

candyjl78

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How we do it...

I don't know what the guidelines are in your state, but we can only bill for field avoidance when the patient is in the prone or lateral position. I saw this once on a Pink Sheet, but I no longer have a copy of it.

Candy Souders, CPC, ACS-AN
Lead Coder (Anesthesia & E/M)
CBIZ Medical Management Professionals
11440 Tomahawk Creek Pkwy
Leawood, KS 66211
(913) 234-1280
 

mcintireh

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From the ASA website:

ASA Relative Value Guide: "Any procedure around the head, neck or shoulder girdle, requiring field avoidance, or any procedure requiring a position other than supine or lithotomy, has a minimum Basic Value of 5.0 regardless of any lesser basic value assigned to such a procedure in the body of the Relative Value Guide."

It is not just positioning but also head, neck, shoulder.

Holly M
 

candyjl78

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Question for Holly M

Could you please direct me to the exact link on the ASA website that states this information. Apparently this information has changed since I started coding.

Thanks!

Candy Souders, CPC, ACS-AN
Lead Coder
CBIZ MMP
:)
 
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