Wiki Help me out With Cpt 00740 & 00810

[Amin C]

Someone can help me out. When we submitted cpt 00740 and 00810 (for anesthesia) together, why insurance paid only one code. thank you

 

[mcnaryk]

Someone can help me out. When we submitted cpt 00740 and 00810 (for anesthesia) together, why insurance paid only one code. thank you

When two (or more) procedures are done at the same time, only the anesthesia code with the most base units is reported. You capture credit for the other procedure in the time reported. 00740 and 00810 both have a base unit value of 3, so I usually bill the one I have the best diagnosis to support. My provider gets credit for both in the total anesthesia time we report on the claim. For example, if a doctor is doing a gallbladder surgery and removes a mole on the arm at the same time, the anesthesia codes would be 00790 for the gallbladder and 00400 for the mole. 00790 has base unit of 7 while 00400 is worth 3 base units, so you would report 00790 with the appropriate diagnosis on you claim. Credit for the mole removal would be reported in the total anesthesia time. So, even though your patient had both a colonoscopy and and EGD at the same time, because the base units are the same you would only report 1 code to get credit for both. In CPT there is a section in the Anesthesia Guidelines: Seperate or Multiple Procedures. I hope this helps!