2023 Coding Update

2023 is proving to be an interesting year for our industry!  Our team released a 2023 update in December with detailed information on code updates as we continue our commitment to keeping our friends up-to-date with everything “anesthesia coding.”

In reviewing the CPT Assistant article from December 2022, our ACE team has noted that CPT codes that describe perineural blocks cannot be used to report procedures that target fascial planes, as the work is vastly different. For these services, CPT Assistant is identifying fascial plane blocks that will be reported as unlisted procedure 64999.

Here’s a friendly reminder about CPT code changes related to image guidance included/bundled that began 1/1/2023: 

• Image guidance may still be reported separately for:
  • 64400, 64405, 64408, 64420, 64421, 64425, 64430, 64435, 64449, 64450
• Image guidance is now included/bundled for:
  • 64415, 64416, 64417, 64445, 64446, 64447, 64448, 64451, 64454 

Finally, to ensure post-op pain block documentation meets requirements, we pose the following questions.
1.  Is there a surgeon’s order?
2.  Is the post-operative pain block (POP) separately identified in the anesthesia plan?
3.  Does the anesthesia record support that the block is not used as the mode of anesthesia for the case?
4.  Does the POP procedure note reference that the block is for postoperative pain and contains the following elements:

• Description of the nature, extent, and need of the procedure for the patient’s condition
• Medical assessment for the procedure
• Surgical time out
• Method/technique utilized
• Drugs and dosage
• Start and Stop times 
• Description of the procedure, including any difficulties and/or patient complications 
• Equipment used
• Imaging (Do Not use a check box)
• Valid signature by the performing physician 

5.  Does the POP procedure note reference a surgeon’s request for the block?
6.  Does the surgeon’s operative note indicate that the block is for post-operative pain and not part of the anesthetic technique for the surgery?
7.  When multiple POP blocks are performed, is the documentation repeated for each separate block?

We would be happy to take a look at any of your documentation to assess risk areas.

Please give us a call or send an email.

The ACE Team
aceadmin@aceauditors.com
913-648-8572