|November 2006 · Vol. 18, No. 11
Modifier needed to bill for anesthesia
RN, CPC-OGS, MA
Anesthesia codes are meant to be billed by anesthesiologists
Independent coding and documentation consultant; former program manager, Department of Coding and Nomenclature, American College of Obstetricians and Gynecologists
Q An external cephalic version was performed on a breech baby as an outpatient procedure. I was told I could bill 01958 (Anesthesia for external cephalic version procedure) for the anesthesia, but have gotten an insurance denial because the “CPT and ICD logic do not match.” We used the diagnostic code 652.2. Are there some rules about anesthesia I should be aware of?
A There may be more than 1 problem here. First, the anesthesia codes are meant to be billed by the anesthesiologist, not the physician who is also performing the procedure. You have not indicated whether this was the case.