|
|
|
|
Modifications in CPT Coding for 2003 Require Careful Attention to Documentation February 4, 2003 - Modifications in the Current Procedural Terminology (CPT-2003) Codes for anesthesia and pain management make it imperative that providers keep accurate records. New codes have been added and old codes have been revised in an attempt to make coding more appropriate. In many cases, expanded CPT language results in better reimbursement. There are four major areas where modifications may change the way you fill out the anesthesia record to ensure accurate coding: arthroscopic anesthesia, thoracotomy procedures, anesthesia for hernia repairs in infants less than one year old, and daily post-op pain rounds. Revised codes for arthroscopy differentiate between diagnostic and surgical scopes (and base units are adjusted accordingly). CPT codes for knee, shoulder, elbow and wrist arthroscopies have been amended so that diagnostic arthroscopy is billed under one code, while open procedures and surgical arthroscopy are included in another. Billing for surgical procedures compared to diagnostic result in a net gain of one base unit per procedure. The anesthesia record should clearly indicate all procedures performed so that our staff can accurately code for the appropriate service. A new code for thoracotomy procedures “utilizing one lung ventilation” has been added to CPT. This code (00541) reimburses three base units more than the code for “throracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified.” Two new anesthesia codes appear in CPT-2003 for hernia repairs in the lower abdomen. The code 00834 applies to children less than one year old. The code 00836 covers infants “less than 37 weeks gestational age at birth and less than 50 weeks gestational age at time of surgery.” Compared with the basic code for hernia repairs, two additional base units are allowed for the premature infant and one additional for the child less than one year old, making gestational age an important detail to be included or verified in the anesthesia record, if possible. Coding for daily pain rounds has been significantly changed this year. CPT added restrictions to the existing code for this service, 01996: “Daily hospital management of epidural or subarachnoid continuous drug administration.” The new (parenthetical) language states, “Report code 01996 for daily hospital management of continuous epidural or subarachnoid drug administration performed after insertion of an epidural or subarachnoid catheter placed primarily for anesthesia administration during an operative session, but retained for post-operative pain management.” The American Society of Anesthesiologists (ASA) advises coding daily rounds with evaluation and management (E/M) codes. We are unsure at this time if Medicare will reimburse for these E/M codes. The ASA is seeking elimination of the new instructions, however even if they are successful, changes will not go into effect until 2004. Therefore, the anesthesia record should clearly state the type of anesthesia provided and, during daily rounds, documentation is necessary for each subsequent care day. |
|
| ||||||||