Anesthesia Codes Updates for 2017

The American Medical Association (AMA) has announced the Anesthesia Coding Updates for 2017. The update comprises nearly 140 new codes, with around 40 falling into Category III. It is time that anesthesia coders and offices gear up for these updates and steer their practice in the right direction for the upcoming year. Some of these updates are as follows:

Epidural Coding Updates

Deletions:

  • 62310: Diagnostic or therapeutic substance(s) injections (includes: anesthetic, steroid, opioid, antispasmodic, other solutions), not including neurolytic substances (needle or catheter placement), includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic.
  • 62311: Sacral or lumbar (caudal).
  • 62318:Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (includes: anesthetic, steroid, opioid, antispasmodic, other solutions), not including neurolytic substances, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic.
  • 62319: Sacral or lumbar (caudal).

Additions:

Choices for single-shot epidurals would be:

  • 62320:Injection(s), of diagnostic or therapeutic substance(s) (anesthetic, steroid, opioid, antispasmodic, other solutions), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance.
  • 62321: with imaging guidance (CT or fluoroscopy).
  • 62322:Injection(s), of diagnostic or therapeutic substance(s) (anesthetic, steroid, opioid, antispasmodic, other solutions), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, sacral or lumbar (caudal); without imaging guidance.
  • 62323: with imaging guidance (CT or fluoroscopy).

The breakdown for continuous infusion or intermittent bolus would be:

  • 62324:Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (anesthetic, steroid, opioid, antispasmodic, other solutions), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance.
  • 62325: with imaging guidance (CT or fluoroscopy)
  • 62326:Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (anesthetic, steroid, opioid, antispasmodic, other solutions), not including neurolytic substances, interlaminar epidural or subarachnoid, sacral or lumbar (caudal); without imaging guidance.
  • 62327: with imaging guidance (CT or fluoroscopy).

Moderate (Conscious) Sedation Coding Updates

It is expected that for the FY 2017, CPT® will remove the conscious sedation symbol from more than 400 codes that are currently carrying the mark. Deletion of current moderate sedation codes is also anticipated. Old codes (99143-99150) will be deleted and will be replaced with new ones (99151-99157), which apply in 15-minute increments rather than the 30 minutes used in the 2016 codes.

Additions:

  • 99151: Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes intra-service time, patient younger than 5 years of age.
  • 99152: Initial 15 minutes intra-service time, patient age 5 years or older.
  • 99153: Each additional 15 minutes of intra-service time.
  • 99155: Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intra-service time, younger than 5 years of age.
  • 99156: Initial 15 minutes intra-service time, patient age 5 years or older.
  • 99157: Each additional 15 minutes of intra-service time.

PQRS Payment Adjustment Updates

In 2015, if an individual Eligible Professional (EP) or Physician Quality Reporting System (PQRS) group practice did not satisfactorily report or participate while submitting data on PQRS quality measures, a negative payment adjustment of 2% will be applied in 2017. The adjustment—which is 98% of the fee schedule amount otherwise applying to such services—applies to covered professional services furnished by a group practice or an individual EP during 2017.

For more updates on anesthesia-related coding changes — CPT® and ASA® for 2017, attend this Webinar by expert speaker Kelly Dennis, MBA, ACS-AN, CANPA, CHCA, CPC, CPC-I, who has over 33 years of experience in anesthesia coding and billing, and speaks about anesthesia issues nationally. This session will help you prepare for the upcoming changes to the Physician Quality Reporting System (PQRS).

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