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Guest
#1 Posted : Thursday, November 29, 2018 1:16:35 PM(UTC)
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Guest

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We are a pediatric dentist wanting to bring in an anesthesiologist to do general anesthesia in our office. We have been trying to find out what we can expect to receive in payment, to know if we will be able to cover the anesthesiologist fees, before we invest in the equipment. I have been researching medical codes and have found we should use 00170 for the general anesthesia and 41899 for the facility code. Is this correct? and If so are there any other codes I should be aware of? I know dental billing but not medical and Dr knows the procedures but not the coding. The anesthesiologist will not due the billing so I must handle it myself. Thank you for any advice you can give!!!

Edited by user Thursday, November 29, 2018 1:17:25 PM(UTC)  | Reason: Not specified

courtneydsnow
#2 Posted : Tuesday, December 4, 2018 8:50:39 AM(UTC)
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courtneydsnow

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Hi Guest!

Great questions. Could you clarify what you mean by "and 41899 for the facility code"?

As for anesthesia coding, here are some coding options below you may run into depending on the types of procedures you offer:

00100 - Anesthesia for procedures on salivary glands, including biopsy
00102 - Anesthesia for procedures involving plastic repair of cleft lip
00160 - Anesthesia for procedures on nose and accessory sinuses; not otherwise specified
00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified
00172 - Anesthesia for intraoral procedures, including biopsy; repair of cleft palate
00176 - Anesthesia for intraoral procedures, including biopsy; radical surgery
00190 - Anesthesia for procedures on facial bones or skull; not otherwise specified
00192 - Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)
01999 - Unlisted anesthesia procedure(s)


If you are offering moderate sedation, here are the coding options below (under 5 years, and 5 & above years):

99152
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 of intraservice time, patient age 5 years or older

99153
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; each additional 15 minutes intraservice time (list separately in addition to code for primary service)

99155
Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger than 5 years of age

99156
Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient age 5 years or older

99157
Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; each additional 15 minutes intraservice time (list separately in addition to code for primary service)


There are also some modifier you may end up using, here are some common options below:

AA Anesthesia services performed personally by an 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 a patient who has a history of severe cardiopulmonary condition
QK Medical direction of two, three or four concurrent anesthesia procedures involving qualified individuals
QS Monitored anesthesia care service
QX CRNA service; with medical direction by a physician
QY Medical direction of one certified registered nurse anesthetist (CRNA) by an anesthesiologist
QZ CRNA service; without medical direction by a physician
23 Unusual anesthesia - Used to report a procedure which usually requires either no anesthesia or local anesthesia; however, because of unusual circumstances must be done under general anesthesia. Coverage/payment will be determined on a "by-report" basis.



A great resources to find out what the average fees other healthcare providers in your area are charging is https://www.fairhealthconsumer.org/


Hope this helps!
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