Anesthesia HCPCS/CPT codes include all services integral to the anesthesia procedure such as preparation, monitoring, intra-operative care, and post-operative care until the patient is released by the anesthesiologist to the care of another physician.
Which Services Are Included?
Examples of integral services include, butare not limited to, the following:
- Transporting, positioning, prepping, draping of the patient for satisfactory anesthesia induction/surgical procedures.
- Placement of external devices necessary for cardiac monitoring, oximetry, capnography, temperature, EEG,CNS evoked responses (e.g., BSER), doppler flow.
- Placement of peripheral intravenous lines necessary for fluid and medication administration.
- Placement of airway (endotracheal tube, orotracheal tube, etc.).
- Laryngoscopy (direct or endoscopically) for placement of airway (endotracheal tube, etc.).
- Placement of naso-gastric or oro-gastric tube.
- Intra-operative interpretation of monitored functions (blood pressure, heart rate, respirations, oximetry, capnography, temperature, EEG, BSER, Doppler flow, CNS pressure).
- Interpretation of laboratory determinations (arterial blood gases such as pH, pO2, pCO2, bicarbonate, hematology, blood chemistries, lactate, etc.) by theanesthesiologist/CRNA.
- Nerve stimulation for determination of level of paralysis or localization of nerve(s). (Codes for EMG services are for diagnostic purposes for nervedysfunction. To report these CPT codes a complete diagnostic report must be present in the medical record.)
- Insertion of urinary bladder catheter
- Blood sample procurement through existing lines or requiring only venipuncture or arterial puncture.
The NCCI contains many edits bundling standard preparation, monitoring, and procedural services into anesthesia CPT codes.
Although some of these services may never be reported on the same date of service as an anesthesia service, many of these services could be provided at a separate patient encounter unrelated to the anesthesia service on the same date of service.
Providers may utilize modifier 59 to bypass the edits under these circumstances. CPT codes describing services that are integral to an anesthesia service include but are not limited to, the following:
- CPT 31505, CPT 31515 & CPT 31527 (Laryngoscopy) (Laryngoscopy codesare for diagnostic or surgical services).
- CPT 31622, CPT 31645 & CPT 31646 (Bronchoscopy).
- CPT 36000 – CPT 36015 (Introduction of needle or catheter).
- CPT 36400 – CPT 36440 (Venipuncture and transfusion).
- CPT 62310 – CPT 62311 & CPT 62318 – CPT 62319 (Injection of diagnostic or therapeutic substance).
CPT codes 62310 – CPT 62311 and CPT 62318 – CPT 62319 may be reported on the date of surgery if performed for postoperative pain relief rather than as the means for providing the regional block for the surgical procedure.
If a narcotic or other analgesic is injected through the same catheter as the anesthetic, CPT codes 62310 – CPT 62319 should not be billed.
Modifier 59 will indicate that the injection was performed for postoperative pain relief but a procedure note should be included in the medical record.