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Anesthesia coding compliance

  1. Default Anesthesia coding compliance
    Medical Coding Books
    Ok I need opinions from everyone. I do anesthesia coding and we had an issue come up. OP report states a hysterectomy abdominal approach. The CRNA wants the vaginal approach coded (00944) instead of abdominal (00840) because they are both the same units and I am coding for accuracy and using 00944 is not a compliance issue. What are your thoughts?

  2. #2
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    Quote Originally Posted by cingram View Post
    Ok I need opinions from everyone. I do anesthesia coding and we had an issue come up. OP report states a hysterectomy abdominal approach. The CRNA wants the vaginal approach coded (00944) instead of abdominal (00840) because they are both the same units and I am coding for accuracy and using 00944 is not a compliance issue. What are your thoughts?
    The fact that the units are the same does not make it acceptable to use an incorrect code - if you are knowingly submitting incorrect information that is not supported in documentation, you cannot say definitively that it is not a compliance issue because it is not possible to know how these codes will be ultimately be used by the payers. Although the reimbursement might be the same for the two codes, it could still potentially cause a financial error because different codes may have different coverage requirements, be in different benefit categories, or be reported differently for calculation of risk or morbidity. It is a risky practice to assume that incorrect coding is not a problem simply because the codes in question are of the same value.

    What it the CRNA's rationale for wanting an incorrect code submitted? There is no valid reason I can think of for doing this. If the procedure was actually a vaginal approach, then the documentation should be corrected. If it is not, then the correct code should be used.
    Last edited by thomas7331; 12-31-2018 at 10:35 AM.
    Thomas Field, CPC, CEMC

  3. #3
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    Knoxville Tennessee
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    Quote Originally Posted by thomas7331 View Post
    The fact that the units are the same does not make it acceptable to use an incorrect code - if you are knowingly submitting incorrect information that is not supported in documentation, you cannot say definitively that it is not a compliance issue because it is not possible to know how these codes will be ultimately be used by the payers. Although the reimbursement might be the same for the two codes, it could still potentially cause a financial error because different codes may have different coverage requirements, be in different benefit categories, or be reported differently for calculation of risk or morbidity. It is a risky practice to assume that incorrect coding is not a problem simply because the codes in question are of the same value.

    What it the CRNA's rationale for wanting an incorrect code submitted? There is no valid reason I can think of for doing this. If the procedure was actually a vaginal approach, then the documentation should be corrected. If it is not, then the correct code should be used.
    I agree. 00944 is not the correct code for abdominal approach. 00840 would be the correct ASA code for this and that's how I would bill it.

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    By kparkhurst in forum Auditing General Discussion
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    Last Post: 03-24-2011, 10:19 AM

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