Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AAPC Chapter 16: Anesthesia > AAPC Chapter 16: Anesthesia Notes > Flashcards

AAPC Chapter 16: Anesthesia Notes Flashcards

1
Q

How are anesthesia codes are grouped?

A

Anatomically (beginning with the head).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In addition to anatomic sections, what other sections are included in the Anesthesia section (4)?

A

Radiological Procedures, Burn Excisions or Debridement, Obstetric, Other Procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When codes are not found under the surgical description, how should the medical coder search for an anesthesia code?

A

By anatomic location (e.g., a simple mastectomy is listed under Anesthesia/Breast, not Anesthesia/ Mastectomy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the default code to report unlisted anesthesia services?

A

01999 Unlisted anesthesia procedure(s).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the three different types of anesthesia?

A

General, regional, monitored anesthesia care (MAC).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Type of anesthesia with drug-induced loss of consciousness.

A

General anesthesia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Type of anesthesia with a loss of sensation in a region of the body.

A

Regional anesthesia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Regional anesthesia for surgeries performed below the upper abdomen where an anesthetic agent is injected in the subarachnoid space into CSF in the spinal canal.

A

Spinal anesthesia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Regional anesthesia where an anesthetic agent is injected in the epidural space; a small catheter may be placed for continuous treatment or to assist with postoperative pain.

A

Epidural anesthesia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Regional anesthesia where an anesthetic agent is injected directly into the area around a nerve to block sensation in the surgical region (commonly used for procedures on the arms or legs).

A

Nerve block anesthesia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Type of anesthesia where the patient is under light or no sedation in surgery with local anesthesia provided by the surgeon; patient can respond to purposeful stimulation and maintain an airway.

A

Monitored anesthesia care (MAC).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Type of anesthesia that is monitored by an anesthesia provider who is prepared to convert to general anesthesia, if necessary.

A

Monitored anesthesia care (MAC).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A physician who has completed an accredited anesthesiology program.

A

Anesthesiologist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

These physicians personally perform, medically direct, or medically supervise members of an anesthesia care team.

A

Anesthesiologist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

An advanced practice registered nurse (APRN) who has completed an accredited nurse anesthetist training program.

A

Certified registered nurse anesthetist (CRNA).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

May be medically or non-medically directed by an anesthesiologist.

A

Certified registered nurse anesthetist (CRNA).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Has a premedical background, a baccalaureate degree, and a master’s degree from an accredited anesthesia assistant training program.

A

Certified anesthesiologist assistant (CAA).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

May only be medically directed by an anesthesiologist.

A

Certified anesthesiologist assistant (CAA).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A physician who has completed his medical degree and is in a residency program specifically for anesthesiology training.

A

Anesthesia resident.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Occurs when one lung is ventilated and the other is collapsed temporarily to improve surgical access to the lung or thoracic cavity.

A

One-Lung Ventilation (OLV).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Term used when a cardiopulmonary bypass (CPB) machine is used to function as the heart and lungs during heart surgery.

A

Pump oxygenator.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When a CPB machine is used, what should the anesthesia record should describe?

A

When the patient went on and off pump.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When a pump oxygenator is not used during heart surgery, what is the surgeon is operating on?

A

A beating heart.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Term that describes organs within the peritoneal cavity (upper or lower abdominal cavity).

A

Intraperitoneal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Intraperitoneal organs in the upper abdomen include…

A

Stomach, liver, gallbladder, spleen, jejunum, ascending and transverse colon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Intraperitoneal organs in the lower abdomen include…

A

Appendix, cecum, ileum, sigmoid colon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Describes the anatomical space in the abdominal cavity behind or outside the peritoneum (upper or lower abdomen).

A

Extraperitoneal or retroperitoneal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Extraperitoneal organs of the upper abdomen include…

A

Kidneys, adrenal glands, lower esophagus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Extraperitoneal organs of the lower abdomen include…

A

Ureters, urinary bladder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Organs in the retroperitoneum include…

A

Aorta, inferior vena cava.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Surgery that is usually extensive, complex, and intended to correct a severe health threat such as a rapidly growing cancer.

A

Radical surgery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Example of a radical surgery?

A

Radical hysterectomy: involves removal of the uterus, cervix, upper part of the vagina, and tissues supporting the uterus and lymph nodes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Arthroscopic procedures may be performed on which joints?

A

Temporomandibular (TMJ), shoulder, elbow, wrist, hip, knee, ankle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

For arthroscopic surgeries, do you assign a diagnostic code when a surgical procedure is performed?

A

No (e.g., if knee arthroscopy is listed as diagnostic and a meniscectomy is performed, a surgical arthroscopic meniscectomy code is assigned without a code for the diagnostic procedure).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Who is typically responsible for postoperative pain management?

A

The surgeon: payment is bundled into the surgeon’s global fee.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

When can postoperative pain management be requested by the surgeon and billed separately by an anesthesiologist?

A

When anesthesia for the surgical procedure is not dependent on efficacy of the regional anesthetic technique.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Postoperative pain management coding depends on which three components?

A

Material injected, site of the injection and placement of either a single injection block or a continuous block by catheter (infusion).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Post-operative pain management by an anesthesiologist is appended with which modifier to signify that the service is separate and distinct from the anesthesiologist’s care during the surgery.

A

Modifier 59 Distinct Procedural Services.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Are surgery and radiology codes reported with time units?

A

No, they are flat-fee and no time is reported separately; only anesthesia codes are reported with time units.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Are codes reported separately for ultrasound or fluoroscopic guidance utilized for pain management procedures?

A

Yes, unless the code includes imaging guidance (fluoroscopy or CT).

41
Q

Which modifier is used for codes reported separately for ultrasound or fluoroscopic guidance utilized for pain management procedures?

A

Modifier 26 Professional Component.

42
Q

When may nerve block codes be used as an adjunct to general anesthesia?

A

When nerve block placement is for postoperative pain management; they should not be reported separately if the block is the type of anesthesia used during the procedure.

43
Q

How are continuous infusion catheter codes reported?

A

If placed for operative anesthesia, the appropriate anesthesia code plus time is reported (01996); if placed only for postoperative pain management, daily catheter management is included in 64448 (do not report 01996).

44
Q

When can anesthesiologists report an E/M service to re-evaluate postoperative pain?

A

When documentation supports the necessity.

45
Q

How many cervical vertebrae in the spinal column?

A

7 cervical vertebrae.

46
Q

How many thoracic vertebrae in the spinal column?

A

12 thoracic vertebrae.

47
Q

How many lumbar vertebrae in the spinal column?

A

5 lumbar vertebrae.

48
Q

How many sacral vertebrae in the spinal column?

A

5 sacral vertebrae (fused together to form the sacrum).

49
Q

Which vertebrae support the ribs?

A

T1 through T10.

50
Q

When is epidural reported?

A

When anesthesia is injected into the epidural space of the spine, including the cervical, thoracic or lumbar area.

51
Q

When is subarachnoid or spinal anesthesia reported?

A

When anesthesia, opioids, or steroids are injected into the subarachnoid or CSF space.

52
Q

When an epidural or subarachnoid catheter is placed for a laboring patient, are injection codes typically reported?

A

No.

53
Q

Where are codes for labor epidural/ subarachnoid services listed?

A

In the Obstetric section of anesthesia codes.

54
Q

When is daily hospital management of continuous epidural or subarachnoid drug administration (01996) reported?

A

Starting on the first postoperative day (not on the day of epidural or subarachnoid catheter placement).

55
Q

Are the diagnoses listed on the pre-anesthesia assessment routinely reported?

A

No.

56
Q

When are diagnosis codes to report the history of a condition reported?

A

Only when the history is relevant to the current condition.

57
Q

Does the medial coder code the preoperative diagnosis or postoperative diagnosis?

A

The postoperative diagnosis, because the preoperative diagnosis may change intraoperatively.

58
Q

Is routine postoperative pain coded?

A

No.

59
Q

When the provider is treating non-routine postoperative pain, select a code from which category?

A

Category G89, based on whether the pain is documented as acute or chronic.

60
Q

For Category G89, when pain is not stated as acute or chronic, how is it coded?

A

Code to acute.

61
Q

When the underlying condition causing the pain is treated, which is coded first: the underlying condition or the code for pain (Category G89)?

A

List the condition first and, if appropriate, report a second code from G89 (see ICD-10-CM guideline I.C.6.b).

62
Q

Example: A patient has surgery for a herniated disc causing chronic back pain.

A

Code for a herniated disc but not the chronic back pain.

63
Q

Example: anesthesia provider places an epidural for acute postoperative back pain.

A

Report the diagnosis code for a herniated disc (M51.9) and acute postoperative pain (G89.18).

64
Q

Are unusual forms of monitoring (e.g., arterial lines, central venous catheters, and pulmonary artery catheters (eg, Swan-Ganz)) included in the anesthesia code?

A

No, they are not included and may be separately reported.

65
Q

Each anesthesia code has what type of value assigned?

A

A base unit value, BUV (not listed separately in the CPT®).

66
Q

Which organization determines base unit values for anesthesia codes and publishes a Relative Value Guide® including the base unit values assigned to each anesthesia code?

A

The American Society of Anesthesiologists (ASA).

67
Q

How are BUVs determined?

A

By difficulty of the procedure performed.

68
Q

Two initial steps in calculating anesthesia charges?

A

Determining the BUV, time reporting.

69
Q

When does anesthesia time begin?

A

When the anesthesiologist begins to prepare the patient for anesthesia in either the operating room or an equivalent area.

70
Q

Is the pre-anesthesia assessment time part of reportable anesthesia? Why or why not?

A

No, because it is considered in the base value assigned.

71
Q

When does anesthesia time end?

A

When the anesthesiologist is no longer in personal attendance (generally when patient is safely transferred to PACU or equivalent unit).

72
Q

Does anesthesia time need to be continuous?

A

No.

73
Q

Is there national guidance regarding time reporting on claims?

A

No: time reporting on claims may vary between local areas (there is no national guidance).

74
Q

Does medicare round anesthesiology time to the nearest 5 minutes?

A

No, Medicare requires exact time reporting without rounding to the nearest five minutes.

75
Q

For Medicare: if the reported anesthesia time is 57 minutes and the procedure has a base value of 6 units, what would the total Medicare payment equal in Bakersfield, California (anesthesia conversion factor of $22.02)?

A

$215.80 (9.8 x $22.02 = $215.80).

9.8 = 6 base value units and 3.8 time units (57/15).

76
Q

Why should anesthesia coders validate insurance carrier time increments prior to billing a claim?

A

Because other insurance companies may process anesthesia time in different increments varying from exact time (like Medicare), to 10, 12, or 15 minutes (or other increments).

77
Q

Example: Anesthesia time = 120 minutes, 2022 national conversion factor: $21.5623. What would be the total Medicare payment? Commercial insurance payment (10 minute increments)?

A

Medicare: Base Value 3, Time (120 min/15) 8, Total units 11 x $21.5623 = $237.19.

Commercial Insurance: Base Value 3, Time (120 min/10) 12, Total units 15 x $21.5623 = $323.43.

78
Q

What is reported when multiple surgical procedures are performed on one patient during anesthesia administration?

A

The surgery representing the most complex procedure, because this service carries a higher BUV (anesthesia time is reported as usual).

79
Q

When multiple surgical procedures are performed on one patient during anesthesia administration, is Modifier 51 (Multiple Procedures) used?

A

No, because only procedure is reported.

80
Q

Only one anesthesia code is reported during anesthesia administration… with what exception?

A

In the case where there is an anesthesia add-on code.

81
Q

When multiple surgical procedures are performed on one patient during anesthesia administration, how is time reported?

A

Total time for all procedures is reported as anesthesia time.

82
Q

A patient has two surgical procedures during one operative session: inguinal herniorrhaphy (00830, 4 base units) and ventral herniorrhaphy (00832, 6 base units). Which procedure(s) are reported?

A

Only the ventral herniorrhaphy (00832) is reported because it is more complex and has a higher base value. But remember: both diagnosis codes are still reported! May help to explain why the reported anesthesia time is longer than normally expected for the procedure reported.

83
Q

Anesthesia add-on codes used to report anesthesia services performed under difficult circumstances that have a significant effect on the character of an anesthesia service.

A

Qualifying Circumstance (QC) codes.

84
Q

Can more than one QC code be listed?

A

Yes, when applicable, unless the reported CPT® code already contains the risk factor (indicated with a parenthetical reference).

85
Q

What kinds of codes are QC codes?

A

Add-on codes: they cannot be reported without an associated anesthesia procedure code.

86
Q

Are QC codes recognized by Medicare for additional payment?

A

No.

87
Q

Do QC codes have base values listed in CPT®?

A

No.

88
Q

Who assigns BUVs for the qualifying circumstances.

A

The American Society of Anesthesiologists (ASA).

89
Q

QC code: Anesthesia for patient of extreme age, younger than 1 year and older than 70.

A

+99100.

90
Q

+99100: how many extra units?

A

1 extra unit.

91
Q

QC code: Anesthesia complicated by utilization of total body hypothermia.

A

+99116.

92
Q

+99116: how many extra units?

A

5 extra units.

93
Q

QC code: Anesthesia complicated by utilization of controlled hypotension.

A

+99135.

94
Q

+99135: how many extra units?

A

5 extra units.

95
Q

QC code: Anesthesia complicated by emergency conditions (specify).

A

+99140.

96
Q

+99140: how many extra units?

A

2 extra units.

97
Q

Emergency conditions do not apply to which situations?

A

After normal-hour care or routine obstetric labor.

98
Q

To review: calculation of anesthesia services for for Medicare.

A

(BASE + TIME) X Medicare conversion factor for the region.

99
Q

To review: calculation of anesthesia services for for non-Medicare.

A

(BASE + TIME + PHYSICAL STATUS MODIFERS + QUALIFYING CIRCUMSTANCES) X conversion factor for non-Medicare payers.

AAPC Chapter 16: Anesthesia (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions