2. Significant Anesthesia Coding Changes in 2017
Anesthesia coding is complex. Coders in reliable medical billing companies stay up-to-date with the latest advances, guidelines, and specific recommendations to help providers submit accurate claims and get properly reimbursed for service provided. Anesthesiologists are facing several coding and reimbursement changes in 2017.
Four CPT codes were deleted and eight new codes have
been added for Epidural Steroid Injections (ESI).

3. CPT Code Additions 62320 Injection (s)
The new code set is based on single injection versus catheter placement for continuous infusion/intermittent bolus and whether imaging guidance was used.
62320 Injection (s)
Injection (s) of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution) not including neurolytic substances including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance

4. CPT Code Additions 62321 Injection (s) 62322 Injection (s)
Injection (s) of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution) not including neurolytic substances including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (i.e., fluoroscopy or CT)
62322 Injection (s)
Injection (s) of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution) not including neurolytic substances including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance

5. CPT Code Additions 62323 Injection (s) 62324 Injection (s)
Injection (s) of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution) not including neurolytic substances including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (i.e., fluoroscopy or CT)
62324 Injection (s)
Injection (s) of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution) not including neurolytic substances including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance

6. CPT Code Additions 62325 Injection (s) 62326 Injection (s)
Injection (s) of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution) not including neurolytic substances including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (i.e., fluoroscopy or CT)
62326 Injection (s)
Injection (s) of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution) not including neurolytic substances including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance

7. CPT Code Additions 62327 Injection (s) www.outsourcestrategies.com
Injection (s) of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution) not including neurolytic substances including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (i.e., fluoroscopy or CT)

8. Deleted CPT Codes 62310 Injection (s) 62311 Injection (s)
Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic
62311 Injection (s)
Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid; lumbar or sacral (caudal)

9. Deleted CPT Codes 62318 Injection (s) 62319 Injection (s)
Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic
62319 Injection (s)
Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, includes contrast for localization when performed, epidural or subarachnoid; lumbar or sacral (caudal)

10. Changes in Moderate Conscious Reporting
In 2017, any service less than 10 minutes in duration is not reported separately. 
Medical billing for Moderate (Conscious) Sedation is based on the intra-service time, which starts with the administration of the sedation agent, requires continuous face-to-face attendance, and ends at the conclusion
of personal contact, by the physician or Qualified
Health Care Professional (QHCP).

11. Changes in Moderate Conscious Reporting
Moderate (Conscious) Sedation was completely restructured in 2017.
Deleted Codes
99143, 99144, and – moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service and further specified by age of patient and intraservice time.
99148, 99149, and – moderate sedation provided by a physician or other qualified healthcare professional other than the physician performing the procedure.

12. Changes in Moderate Conscious Reporting
Added Codes
99151, 99152, and replaced The intraservice time has decreased from the initial 30 minutes to 15. Additional intraservice time increments remain at 15.
99155, 99156, and replaced – The intraservice time decreased to an initial 15 minutes from 30.

13. CPT Guideline Updates
Addition of a new parenthetical comment for code indicates that one should not bill moderate sedation with or (anesthesia for chronic pain injections). Moderate sedation codes and anesthesia codes are mutually exclusive; bill one or the other, not both.
A new comment states that when moderate sedation is performed by a physician other than the physician performing the procedure, the
physician performing moderate sedation can only bill
if the procedure is performed in the facility.
Moderate sedation is not Monitored Anesthesia Care
(MAC) or deep sedation.
Medical billing companies that stay current with the coding and billing changes that impact the provider’s reimbursement can help ensure accurate anesthesiology billing.

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