Paul, I have similar questions to go along with your question about anesthesia or surgery coding. These questions are under the assumption that billing anesthesia services with surgery codes will still be allowed.
Since TOS is not part of the 837, how can I identify a line item as being an anesthesia service? As a repricer of claims, the service type can dictate the conversion factor, code weight and equation used to calculate the allowed amount. I can easily identify the surgery, radiology, E&M, etc. codes by the CPT/HCPCS code submitted, but what about anesthesia services? I realize that I can look for the true anesthesia CPT/HCPCS codes (CPTs 00100 up to about 02000, various HCPCS codes) or the 10 or so modifiers that are associated with anesthesia services, but what about the surgery codes that are now submitted with the TOS = 7? I want to require that the actual minutes are submitted with all anesthesia services (SV103 = MJ), but how can I catch those that aren't if I can't identify the type of service? Thanks for any help offered. Dave Sell The Alliance 608-210-6656 [EMAIL PROTECTED] -----Original Message----- From: Paul Costello [mailto:[EMAIL PROTECTED] Sent: Monday, March 10, 2003 12:23 PM To: WEDI SNIP Transactions Workgroup List Subject: Re: RE: Anesthesia v. Surgical Codes Linda, I respectfully disagree with you. If you look at the "body" of the transaction and code set rule that addressess the medical data code sets, the rule states that certain "sets" of codes (ICD-9, CPT, HCPCS) must be used for certain types of procedures, etc. The rule never says that Anesthesia CPT codes are required when coding for anesthesia services - the rule says the CPT/HCPCS codes must be used. Paul ----- Original Message ----- From: Linda McCardel <[EMAIL PROTECTED]> Date: Monday, March 10, 2003 7:43 am Subject: RE: Anesthesia v. Surgical Codes > Paul - Only the Anesthesia CPT codes are acceptable effective 10- > 16-03. - > using the CPT surgical codes is not an acceptable use of the code > structurebeginning 10-16-03 - that is what the Final Rule is > saying. > > -----Original Message----- > From: Paul Costello [mailto:[EMAIL PROTECTED] > Sent: Friday, March 07, 2003 3:00 PM > To: WEDI SNIP Transactions Workgroup List > Subject: Anesthesia v. Surgical Codes > > > Group, > > I know this topic has been addressed in the past, but I wanted to ask > again... > > When reporting anesthesia services, which codes (anesthesia CPT or > surgicalCPT or either) are required? > > A paragraph from the Standards for Electronic Transactions final > rule (page > 50361 of the August 17, 2000 Federal Register) states: > > "... there is significant variation in the reporting of anesthesia > services,with some health plans using the anesthesia section of > CPT, and other > requiring the anesthesiologist or nurse anesthetist to report the > code for > the surgical procedure itself. When the HIPAA code sets become > effective,health plans following the later convention will have to > begin accepting > codes from the anesthesia section [of CPT]." > > I read this to mean that both types of codes will be allowed, not just > anesthesia CPT codes. > > I have seen other documentation that implies that only anesthesia > CPT codes > will be allowed. > > Thoughts? > > Thanks, > Paul > > > > --- > The WEDI SNIP listserv to which you are subscribed is not > moderated. The > discussions on this listserv therefore represent the views of the > individualparticipants, and do not necessarily represent the views > of the WEDI Board > of Directors nor WEDI SNIP. If you wish to receive an official > opinion, post > your question to the WEDI SNIP Issues Database at > http://snip.wedi.org/tracking/. These listservs should not be > used for > commercial marketing purposes or discussion of specific vendor > products and > services. They also are not intended to be used as a forum for > personaldisagreements or unprofessional communication at any time. > > You are currently subscribed to wedi-transactions as: > [EMAIL PROTECTED] unsubscribe from this list, go to the > Subscribe/Unsubscribe form at > http://subscribe.wedi.org or send a blank email to > [EMAIL PROTECTED] > If you need to unsubscribe but your current email address is not > the same as > the address subscribed to the list, please use the > Subscribe/Unsubscribeform at http://subscribe.wedi.org > > --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
