1. Chapter 3
Anesthesia

2. Providers of Anesthesia
Who can perform Anesthesia?
A anesthesiologist, certified registered nurse anesthetists (CRNA’s) or anesthesiologist assistants (AA’s) can perform anesthesia.

3. Codes Anesthesia code range is 00100-01999.
These codes are arranged by body site first beginning with the head, and then by the specific procedure performed.
These codes may be found in the alphabetical index under anesthesia or analgesia.

4. Types of Anesthesia
Local anesthesia: injection of a numbing agent directly into the area of the body to block the pain in minor procedures.
Regional anesthesia: this injection is applied to a larger area of body surface. Example would be a epidural or a spinal block.
General anesthesia: anesthetic is administered intravenously or inhaled. The patient is unconscious during the surgery.

5. How to find your code
Anesthesia for diagnostic arthoscopy of the knee.
1. Look in the alphabetic index, under anesthesia.
2. Look for subterm Arthroscopic Procedures and find knee.
3. Code choices should be 01382,
4. Look at both codes and pick the best one.

6. 01382 is your answer!!!!!!!

7. Conscious Sedation
This produces a level of consciousness that retains the patient’s ability to independently and continuously maintain a airway and respond appropriately to physical stimulation or verbal command.
If done by a physician performing the procedure requiring moderate conscious sedation use If done by a physician other than the healthcare professional performing the procedure requiring conscious sedation use

8. Beginning and Ending Time
Anesthesia begins when the anesthesiologist starts to prep the patient for induction of anesthesia (usually in the operating room).
Anesthesia ends when the anesthesiologist is no longer in attendence.

9. Modifiers
Physical status modifiers indicate the patient’s condition and therefore the complexity of the anesthesia service.
Physical status modifiers are assigned during the pre-anesthesia interview with the patient.
P1- normal, healthy P2- mild systemic disease
P3- severe systemic disease
P4- severe systemic disease, but constant threat to life
P5- moribund patient not expected to survive without surgery
P6- brain dead patient, organ donation

10. Other Modifiers Other modifiers used with anesthesia are: -22 -23 -51
-53
-59
Look each modifier up in your CPT book!

11. HCPCS Level II Modifiers
When coding HCPCS level II codes you may need to use the following modifiers:
AA QY AD G8 G9 QK QS
Look these modifiers up in the HCPCS book.

12. Specific to CRNA coding
When a CRNA is providing anesthesia you may use the following modifiers:
QX- CRNA service with direction of a physician.
QZ- CRNA service without direction of a physician.

13. Other codes used to Report Circumstances
Sometimes there are unusual circumstances surrounding the patient’s condition.
reports a patient under 1 year or over 70 years old.
reports complication due to body hypothermia.
reports complication due to hypotension.
reports complication of emergency conditions.

14. Calculating Fees
The charge for anesthesia is based on the following formula:
Base unit + time unit + modifying factors X conversion factor.
Example:
(5 base units+8 time units+1 modifying factor) X $50

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