Securing successful contracts with payers is becoming increasingly important for ASCs as they move toward negotiating value-based contracts. Lisa Davis, administrator at The Center for Minimally Invasive Spine in Munster,…
Coding your anesthesia provider’s service is never cut and dried, especially with intricate procedures such as retrobulbar block placement. Answer these three questions regarding your anesthesiologist’s involvement in the case to know how to correctly code her services every time.
Does The Anesthesiologist Handle Everything?
Because administering anesthesia for retrobulbar blocks is riskier than other ocular injections, some surgeons (or facilities) prefer to have the anesthesia team handle everything. If your anesthesiologist is involved throughout the case, she administers the initial block and then administers monitored anesthesia care (MAC) during the case.
Code it: Your anesthesiologist places the block in preparation for the procedure, not as a separate pain management service. Therefore, you only code for the eye procedure instead of the procedure and block. Choose the appropriate code from 00140-00148 (Anesthesia for procedures on eye …). Depending on carrier requirements, append modifier QS (Monitored anesthesia care service) to indicate MAC, says Kelly Dennis, MBA, ACS-AN, CANPC, CHCA, CPC, CPC-I, owner of Perfect Office Solutions in Leesburg, Fla.
Expect your anesthesiologist to report discontinuous time in this scenario. She will place the block, leave the room while the block takes effect, and return in time for the procedure. Because she won’t be with the patient from start to finish, watch your time units. Calculate the time she spends placing the block and with the patient during the procedure for the total minutes.
Caution: Patients needing retrobulbar blocks often are scheduled back to back, which can make tracking your anesthesia provider’s time tricky. Be careful to ensure that case times don’t overlap when calculating the number of cases your anesthesiologist medically directs or supervises. Some practices decide to avoid potential compliance risks by not trying to capture the discontinuous time.
Does the Anesthesiologist Only Monitor?
Some facilities — and many...
Your orthopedist injects both of a patient’s wrists to treat carpal tunnel syndrome. Should you just file 20526 with modifier 50 appended and forget about it? Not so fast: If the physician injects both the patient’s wrists to treat CTS, you will ty...
600 coders, physicians, and office managers gathered in Orlando, Fla. for one and a half jam-packed days of education, networking, and shopping at the December 2011 Coding Update and Reimbursement Conference. Coders’ biggest struggle was absorbing all the information – and not overdoing the holiday buying. Experts offered the inside scoop on medical coding changes for 2011 and beyond. Here are my top picks:
This...
Have your documentation ready for reporting level P4 and higher.
Physical status modifiers, also referred to as P modifiers, PS modifiers, ASAs or ASA P codes, are an important element of your anesthesia coding. If you don’t use them correctly,...
Sicker patients may not always mean higher MDM.
If your physician bills a lot of high-level office visits, he may be at risk of an audit — which may not be cause for concern — if his documentation justifies his...
Watch frequency and provide documentation to rationalize extra pay.
Applying modifier 22 (Increased procedural services) can help increase reimbursement if your neurosurgeon documents a greater-than-usual effort during a surgical service. To ensure your claims’ success, surgeons and coders must also...
Grasping 93010’s effect on new vs. established patient status could bring a $58 reward.
Whether you call them ECGs or EKGs, chances are you see a lot of electrocardiograms in your practice. That means that even the tiniest coding errors...
Here’s where you can bypass the edits with modifier 59. The Correct Coding Initiative (CCI) version 16.0 didn’t overlook the hysterectomy, vaginal graft, and colpopexy codes — nor should you. To make sense of the deletions, break these additions into mutually exclusive and non-mutually exclusive. Note: In all these cases — except those involving the anesthetic injection [...] Related articles:
Don’t forget to double-check these 2 things to find the correct code. Question: How do I code an epidural blood patch procedure on the same day as labor and delivery? Should I include a modifier? Answer: Administering a blood patch on the same day as labor and delivery is unusual because most physicians try to manage spinal [...] Related articles:
Question: A sleep study was ordered for a patient diagnosed with hypersomnolence. The neurologistincluded a multiple wake test in the sleep study. What CPT code should I use for the multiple wake test? Answer: You should use 95805 (Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during [...] Related articles: