Friday, May 21, 2010

Radiologic Anesthesia Coding


In keeping with standard anesthesia billing guidelines for Medicare, only one anesthesia code may be reported for anesthesia services provided in conjunction with radiological procedures. Radiological Supervision and Interpretation (S & I) codes will usually be applicable to radiological procedures
being performed.

The appropriate S & I code may be reported by the appropriate provider (radiologist, cardiologist, neurosurgeon, radiation oncologist, etc.). Accordingly, S & I codes are not included in anesthesia codes referable to these procedures; only the appropriate provider, however, may bill for S & I services. CPT code 01920 (Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include Swan- Ganz catheter) can be reported for monitored anesthesia care (MAC) in patients who are critically ill or critically unstable.

If the physician performing the radiologic service places a catheter as part of that service, and, through the same site, a catheter is left and used for monitoring purposes, it is inappropriate for either the anesthesiologist/certified
registered nurse anesthetist or the physician performing the radiologic procedure to bill for placement of the monitoring catheter (e.g., CPT codes 36500, 36555-36556, 36568-36569, 36580, 36584, 36597).


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