Question

Learning Objectives for Chapter 24: CPT Anesthesia Section Overview This week we will learn how to find the procedure codes for identifying the administration of anesthetics in the second section of the CPT book, directly after evaluation and management (E/M) codes. Have them note that the anesthesiology codes range from 00100-01999 and 99100 99140. As future professional coders, you should know they will typically use co from this section only if they go to work for an anesthesiologist, in his or her office, or for a billing company that codes ar files claims for anesthesiologists. Point out that generally, anesthesiologists have their own practices. While almost all of their services are provided in a hospital setting, coding will not be done as such because they are not employees of the hospital, and consequently, they must submit their own claim forms to the insurance carrier for their services. 1. Interpret the types of anesthesia provided. 2. Determine the accurate code and physical status modifier for the administration of anesthesia. 3. Incorporate the Official Guidelines for reporting. 4. Apply the formula for using the time to report anesthesia services 5. Select the accurate qualifying circumstances add-on codes. 6. Identify special circumstances requiring a CPT modifier. 7. Abstract the notes to append HCPCS Level Il modifiers.

Answer 1

Anesthesia refers to the medications like sedatives to induce the temporary loss of awareness to the external environment. Types of anesthesia are Local anesthesia, Regional anesthesia, General anesthesia.

CPT code range 99100-99140 are to indicate the anesthesia procedures involved in Head,Neck,Thorax, Intrathoracic,Upper abdomen, lower abdomen, procedures of fore arm, wrist and hand and radiological procedures.

Physical status modifiers are used in anestheia to correspond to the condition of the patient. These codes are:

P1- a normal healthy patient.

P2- a patient with mild systemic disease.

P3- a patient with severe systemic disease.

P4- a patient with severe systemic disease that is constant threat to life.

P5- a moribund patient who is not expected to survive without the operation.

P6- a declared brain dead patient who organs are being removed for donor purposes.

The formula to calculate the time for anesthesia procedure includes:

(Base factor + Total time units) X Anesthesia conversion factor x Modifier adjustment = Allowance.

(Base factor + Total time units) X Anesthesia conversion factor) x Modifier adjustment = Allowance for each provider.

The qualifying circumstances are modifiers billed to provide idea regarding unusual circumstances. 99100 - unit value = 1 administration of anesthesia to patient who is younger than age 1 or older than age 70.

99116 - unit value = 5 Administration of anesthesia complicated by utilization of total body hypothermia.

99135 -unit value = 5 Administration of anesthesia complicated by utilizatin of controlled hypotension.

99140 - unit value =2 Administration of anesthesis complicated by emergency condiitons only.