HANK/ACE: Anesthesia Coding Partner
February 22, 2024CMS Update: LCD proposed changes for Facet Joint Interventions for Pain Management
March 8, 2024In our commitment to keep you well-informed, we would like to share our guidance on two topics that have come across our desks lately – Point of Care Ultrasound (PoCUS) and Glucagon-like peptide-1 (GLP-1).
A great tool for anesthesiologists, Point of Care Ultrasound (PoCUS) aids in procedural guidance and diagnostics. Understanding the appropriate coding and modifiers is essential to ensure accurate billing and reimbursement.
Regular review of coding guidelines helps prevent claim denials, optimizing practice efficiency.
Glucagon-like peptide-1 (GLP-1) agonists may impact a patient’s preoperative care and warrant attention. Concerns regarding delayed gastric emptying prompt recommendations to withhold these medications before procedures.
Adherence to withholding guidelines and consideration of gastrointestinal symptoms are pivotal in mitigating associated risks during the perioperative period.
Documentation Recommendations for Coding PoCUS and GLP-1
Upon thorough research, we’ve noted that Chapters 2 and 9 of NCCI do not specifically disallow PoCUS. Furthermore, there are no edits between the first column ASA codes and CPT 76705 in the second column.
Our team believes this should be something other than routine practice. Otherwise, there is a risk of drawing attention via audit.
When USG is used, anesthesia providers act as radiologists.
Documentation must be completed if the practice is confident that the medical necessity is met. Documentation must include and clearly explain the elements that support medical necessity.
Complete interpretation and report, including confirmation of USG image retention, is needed. A checkbox would not qualify to support the service.
As always, we rely on The American Society of Anesthesiologists newsletters for information and updates.
Here are the links to the information they have released:
Click here for Point of Care Ultrasound (PoCUS)
Click here for Glucagon-like peptide-1 (GLP-1)
Being a resource remains our top priority. Please don’t hesitate to reach out if you require further clarification or assistance. Stay informed, stay proactive!