Anesthesia

Anesthesia means administra on of drug to induce par al or complete loss of sensa on.
Anesthesia code range: 00100- 01999.
Are used by anesthesiologist and CRNA (Cer fied Registered Nurse Anesthesiologist).
*4 ques ons in CPC exam
Used to report service performed or supervised by a physician.
Included services
1. Preopera ve & Postopera ve care
2. Administra on of fluids and/or Blood
3. Monitoring services (Eg: BP, Temperature, ECG, Oximetry, Mass Spectrometry, and Capnography)
Excluded services
Other Monitoring services like Central venous, Intra-arterial and Swan-Ganz
.

Types of anesthesia
 Local
 Regional
 Nerve block
 Epidural
 Spinal
 general

MAC- Monitored Anesthesia Care

Moderately sedated but not in sleep and no endotracheal tube.
Time Report for Anesthesia
 Anesthesia me begins when the anesthesiologist begins to prepare the pa ent for the induc on of
anesthesia in the opera ng room or in an equivalent area and ends when the anesthesiologist is no longer in
personal a endance, that is, when the pa ent may be safely placed under postopera ve supervision.
 me of anesthesia calculated in units
ie 1 unit = 15 minutes
Calcula on of anesthesia charge
anesthesia charge = [baseline procedure unit + physical status modifier unit + qualifying circumstance unit +
anesthesia me unit 1] X conversion value.

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Anesthesia modifiers
AA - Performed by anesthesiologist
AD - Medical supervised by physician; more than 4 concurrent anesthesia procedures
QK - Medical direc on of 2-4 concurrent procedures (cases happening at the same me)
QS - MAC (monitored anesthesia care)
G8 - Monitored anesthesia care (MAC) for deep complex, complicated, or markedly invasive surgical procedures.
G9- Monitored anesthesia care for pa ent who has history of severe cardiopulmonary condi on
QX - CRNA service: with medical direc on by physician
QY- Medical direc on of one CRNA by an anesthesiologist
QZ - CRNA without medical direc on
Physical status modifiers Unit Value

P1 - a normal, healthy pa ent 0

P2 - a pa ent with mild systemic disease 0

P3 - a pa ent with severe systemic disease 1

P4 - a pa ent with severe systemic disease that is a 2
constant threat to life
P5 - a moribund pa ent who is not expected to survive 3
without the opera on
P6 - a declared brain-dead pa ent whose organs are being 0
removed for donor purposes
Qualifying circumstances Unit Value

99100 - This modifier code is recognized for administra on 1

of anesthesia to a pa ent who is younger than age 1 or
older than age 70.
99116 - This modifier code is recognized for administra on
5
of anesthesia complicated by u liza on of total-body
hypothermia.
99135 -This modifier code is recognized for administra on
5
of anesthesia complicated by u liza on of controlled
hypotension.
99140 -modifier code is recognized for the administra on of 0
anesthesia complicated by emergency condi ons only.

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 Ques ons :

1. A 42-year-old with renal pelvis cancer receives general anesthesia for a laparoscopic
radical nephrectomy. The pa ent has controlled type 2 diabetes otherwise no other co-
morbidi es. What is the correct CPT and ICD-10-CM code for the anesthesia services?
A. 00860-P1, C64.9, E11.9
B. 00840-P3, C65.9, E11.9
C. 00862-P2, C65.9, E11.9
D. 00868-P2, C79.02, E11.9

2. A healthy 32-year-old with a closed distal radius fracture received monitored

anesthesia care for an ORIF of the distal radius. What is the code for the anesthesia service?
A. 01830-P1
B. 01860-QS-P1
C. 01830-QS-P1
D. 01860-QS-G9-P1

3. A 10-month-old child is taken to the opera ng room for removal of a laryngeal mass.
What is (are) the appropriate anesthesia code(s) to report?
A. 00320
B. 00326
C. 00320, 99100
D. 00326, 99100

4. A 6-month-old pa ent is administered general anesthesia to repair a cle palate. What

anesthesia code(s) is (are) reported for this procedure?
A. 00170, 99100
B. 00172
C. 00172, 99100
D. 00176

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5. A 50-year-old female had a le subcutaneous mastectomy for cancer. She
now returns for reconstruc on which is done with a single TRAM flap. Right mastopexy is done
for asymmetry. Select the anesthesia code for this procedure.

A. 00404
B. 00402
C. 00406
D. 00400

6. A pa ent is having knee replacement surgery. The surgeon requests that in

addi on to the general anesthesia for the procedure that the anesthesiologist also insert a
con nuous lumbar epidural infusion for postopera ve pain management. The anesthesiologist
performs postopera ve management for two postopera ve days.
A. 01400-AA, 62326, 01996 x 2
B. 01402-AA, 62327, 01966 x 2
C. 01402-AA, 62326, 01996 x 2
D. 01404-AA, 62327

7. A very large lipoma is removed from the chest measuring 8 sq cm and the defect is 12.2
cm requiring a layered closure with extensive undermining. MAC is performed by a medically
directed Cer fied Registered Nurse Anesthe st (CRNA). Code the anesthesia service.
A. 00400-QX-QS
B. 00400-QS
C. 00300-QS
D. 00300-QX-QS
8. PREOPERATIVE DIAGNOSIS: Mul vessel coronary artery disease.
POST-OPERATIVE DIAGNOSIS: Mul vessel coronary artery disease. NAME OF PRO- CEDURE:
Coronary artery bypass gra x 3, le internal mammary artery to the LAD, saphenous vein gra
to the obtuse marginal, saphenous vein gra to the diagonal. The pa ent is placed on heart
and lung bypass during the procedure. Anesthesia me: 6:00 PM to 12:00 AM Surgical me:
6:15 PM to 11:30 PM What is the correct anesthesia code and anesthesia me?
A. 00567, 6 hours
B. 00566, 6 hours
C. 00567, 5 hours and 30 minutes
D. 00566, 5 hours and 30 minutes

9. A 56-year-old receives general anesthesia for an open pleura biopsy. An anesthesiologist

medically directs two other cases, and medically directs a CRNA on this case. What are the
anesthesia codes and modifiers reported for the anesthesiologist and CRNA?
A. 00540-AA, 00540-QZ
B. 00540-QK, 00540-QX
C. 00541-AA, 00540-QZ
D. 00541-QK, 00541-QX

10. A pa ent is given general anesthesia by the anesthesiologist for a "carpal tunnel nerve
release". A er the surgery the anesthesiologist is called to perform an axillary block for
postopera ve pain management on the same pa ent. What are the appropriate CPT codes?
A. 01829-AA, 64417-59
B. 01840-AA, 64417-59
C. 01810-AA, 64417-59
D. 01830-AA, 64417-59

11. A healthy 45-year-old is having a needle thyroid biopsy. The anesthesiologist begins to
prepare the pa ent for surgery at 09:00 am. The surgery begins at 09:15 am and ends at 09:45
am. The anesthesiologist turns over the pa ent's care to the recovery room nurse at 10:00 am.
Which is the appropriate anesthesia code and what is the anesthesia me?
A. 00320, One hour
B. 00320, 45 minutes
C. 00322, 45 minutes
D. 00322, One hour
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12. Pa ent is admi ed in labor for delivery. She received a labor neuraxial epidural for a
vaginal delivery. The baby goes into fetal distress and a cesarean sec on is performed.
Following delivery, the pa ent starts to hemorrhage. The physician decides, with family
approval, to perform a hysterectomy. Code the anesthesia services.
A. 01967, 00840
B. 01962
C. 01968
D. 01967, 01969

13. Angiograms reveal three artery blockages. The pa ent has COPD, which is a severe
systemic disease. The pa ent undergoes a CABG X 3 venous gra s on cardiopulmonary bypass
and cell saver. Code the anesthesia service.
A. 00562-P3
B. 00560-P4
C. 00567-P3
D. 00566-P4

14. A healthy 11-month-old pa ent with bilateral cle lip and palate undergoes surgery. The
surgeon performs a bilateral cle lip repair, single stage. Code the anesthesia service.
A. 00170-P1, 99100
B. 00102-P1
C. 00102-P1, 99100
D. 00170-P1

15. The anesthesiologist performed MAC (monitored anesthesia care) for a pa ent
undergoing an arthroscopy of the right knee. Code the anesthesia service.
A. 01382-AA
B. 01382-AA-QS
C. 01400-AA
D. 01400-AA-QS

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16. General anesthesia is administered to a 9-month-old undergoing a tracheostomy. Code
the anesthesia service.
A. 00320, 99100
B. 00320
C. 00326
D. 00326, 99100

Answers :

1. C (00862-P2, C65.9, E11.9)

2. C (01830-QS-P1)
3. B (00326)
4. C (00172, 99100)
5. B (00402)
6. C (01402-AA, 62326, 01996 x 2)
7. A (00400-QX-QS)
8. A (00567, 6 hours)
9. B (00540-QK, 00540-QX)
10. C (01810-AA, 64417-59)
11. D (00322, One hour)
12. D (01967, 01969)
13. C (00567-P3)
14. C (00102-P1, 99100)
15. B (01382-AA-QS)
16. C (00326)
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