Coding guide for Anesthesia CPT codes 00731, 00732, 00811, 00812 & 00813

 
Medical coders has to use anesthesia cpt codes in the gastro-endoscopic section. CPT code 00731, 00732, 00811, 00812 and 00813 are the added procedure codes in this section.
  
Three anesthesia service CPT codes have been deleted.
 
01180 Anesthesia for obturator neurectomy; extrapelvic
 
01190 intrapelvic
 
01682  Anesthesia for shoulder cast application, removal or repair; shoulder spica
 
The above three codes have been replaced by new anesthesia procedures codes.
 

 Codes description of CPT code 00731, 00732, 00811, 00812 and 00813

 
There are five new CPT codes added for anesthesia of gastro-endoscopic procedures. These new codes will be more specific. Below is the detail code description of these procedure codes.

00731 (Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified).

00732 (…; endoscopic retrograde cholangiopancreatography [ERCP]).

00811 (Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified)

00812 (…; screening colonoscopy)

00813 (Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum).

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Modifiers used with Anesthesia Services CPT codes

We have learnt previously about modifier 26 & TC, modifier 25 & 27, modifier 58,78 & 79 etc used along with CPT codes. similarly we have a list of modifiers used along with anesthesia CPT codes. These are used as primary modifiers when used along with anesthesia codes.

AA   Anesthesia services performed personally by anesthesiologist
AD   Medical supervision by a physician: more than four concurrent anesthesia procedures.
G8   Monitored anesthesia care (MAC) for deep complex, complicated, or markedly invasive surgical procedure
G9   Monitored anesthesia care (MAC) for patient who has history of severe cardiopulmonary condition
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 a constant threat to life
P5   A moribund patient who is not expected to survive without the operation
P6   A declared brain-dead patient whose organs are being removed for donor purposes
QK  Medically directed by a physician: two, three, or four concurrent procedures
QY  Anesthesiologist medically directs one CRNA
QX  CRNA service: with medical direction by a physician
QZ  CRNA service: without medical direction by a physician

 

Secondary Anesthesisa modifiers

Below modifiers are used along with primary modifiers. These modifier should be used as secondary or 2nd position after using any of the primary modifier.

QS   Monitored anesthesia care service
23    Unusual anesthesia
Note: When using modifier 23, appropriate documentation must be submitted with the claim.
33    Preventive Services: When the primary purpose of the service is the delivery of an evidence based service in accordance with a US Preventive Services Task Force A or B rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by adding 33 to the procedure.

Qualifying Circumstances
Though technically not modifiers, these codes serve to describe anesthesia services under unusual or difficult circumstances. Such unusual circumstances and services may qualify for additional reimbursement when reported in addition to the anesthesia code. These codes are not reported alone, but in addition to the qualifying anesthesia procedure or service. More than one CPT code may be used.
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