© 2013 The McGraw-Hill Companies, Inc. All rights reserved. Anesthesia Services Chapter Ten

© 2013 The McGraw-Hill Companies, Inc. All rights reserved © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Learning Outcomes 10.1 Select anesthesia codes based on surgical procedures Report anesthesia time Use anesthesia modifiers and add-on codes Calculate the total number of anesthesia units for services provided Select anesthesia codes for surgical procedures on specific body parts Choose anesthesia codes for specific procedures.

© 2013 The McGraw-Hill Companies, Inc. All rights reserved © 2013 The McGraw-Hill Companies, Inc. All rights reserved Coding for Specific Procedures Rather than describing an anatomical region or body part, some anesthesia codes describe the specific procedures that make the anesthetic necessary, including: Radiological procedures. Burn excisions or debridement. Obstetrical anesthesia. Other procedures.

© 2013 The McGraw-Hill Companies, Inc. All rights reserved © 2013 The McGraw-Hill Companies, Inc. All rights reserved Coding for Specific Procedures (continued) Radiological Procedures (01916–01936) It may be necessary to provide anesthesia for a patient undergoing radiological procedures. This is not typically necessary for routine x-rays to visualize a body part, but it may be needed for radiological procedures that result in sufficient discomfort. CPT codes include: (Anesthesia for diagnostic arteriography/venography) (Anesthesia for cardiac catheterization including coronary angiography and ventriculography [not to include Swan-Ganz catheter])

© 2013 The McGraw-Hill Companies, Inc. All rights reserved © 2013 The McGraw-Hill Companies, Inc. All rights reserved Coding for Specific Procedures (continued) Burn Excisions or Debridement (01951–01953) There are three separate codes that describe anesthesia for the treatment of burns, two base codes and one add-on code. Anesthetics for patients undergoing surgical treatment of second- and third- degree burns are not reported using the codes that describe procedures on the skin in particular anatomical regions. Each area of the body is assigned a percentage value. The TBSA is calculated by adding those percentages for the areas treated during the procedure.

© 2013 The McGraw-Hill Companies, Inc. All rights reserved © 2013 The McGraw-Hill Companies, Inc. All rights reserved Coding for Specific Procedures (continued) Obstetrical Anesthesia (01958–01969) Anesthesia providers perform procedures to produce anesthesia/analgesia for women in labor. This is one of the few services that a single anesthesia provider can perform on multiple patients at the same time. Anesthesia for labor is reported with a procedure code and time units. Because the provider may be caring for multiple pregnant patients with catheters in place at the same time, payers have different conventions and requirements for reporting the time units.

© 2013 The McGraw-Hill Companies, Inc. All rights reserved © 2013 The McGraw-Hill Companies, Inc. All rights reserved Coding for Specific Procedures (continued) Other Procedures (01990–01999) The last few CPT anesthesia codes are miscellaneous codes reporting anesthesia services that are not otherwise classified, including: (Physiological support for harvesting of organ(s) from brain-dead patient) (Anesthesia for diagnostic or therapeutic nerve blocks and injections; other than the prone position) (Anesthesia for diagnostic or therapeutic nerve blocks and injections; prone position) (Daily hospital management of epidural or subarachnoid continuous drug administration)

© 2013 The McGraw-Hill Companies, Inc. All rights reserved © 2013 The McGraw-Hill Companies, Inc. All rights reserved. Summary (continued) Learning Outcome 10.5 Most anesthesia codes are classified according to the anatomical location of the underlying surgical procedure. Learning Outcome 10.6 Some anesthesia services are classified by the type of procedure that makes the anesthesia necessary.