CPC Anesthesia Coding Guidelines 3 — Questions and Answers
Question 1: Which qualifying circumstance code is used when anesthesia is provided for a patient of extreme age, such as a neonate?
- 99100 (Correct answer)
- 99116
- 99135
- 99140
Correct answer: 99100
Code 99100 is reported for anesthesia for patients of extreme age, including neonates and patients under 1 year or over 70 years.
Question 2: A CRNA working under the medical direction of an anesthesiologist would use which modifier?
- QX (Correct answer)
- QZ
- AD
- GC
Correct answer: QX
Modifier QX is used by a CRNA with medical direction by a physician.
Question 3: For anesthesia coding purposes, the total anesthesia time begins when?
- When the patient enters the operating room
- When the anesthesiologist begins preparing the patient for induction (Correct answer)
- When the surgical incision is made
- When the patient is moved to the recovery room
Correct answer: When the anesthesiologist begins preparing the patient for induction
Anesthesia time starts when the anesthesiologist begins preparing the patient for the induction of anesthesia in the operating room area.
Question 4: Which anesthesia code range covers procedures on the thorax (chest wall and shoulder girdle)?
- 00100–00222
- 00300–00352
- 00400–00474 (Correct answer)
- 00500–00580
Correct answer: 00400–00474
CPT codes 00400–00474 cover anesthesia for procedures on the integumentary system of the thorax and shoulder girdle.
Question 5: When an anesthesiologist medically directs two concurrent cases, which modifier does the anesthesiologist use?
- QK
- QY (Correct answer)
- AA
- AD
Correct answer: QY
Modifier QY is used when a physician medically directs one CRNA, while QK is used when directing 2–4 concurrent CRNA cases.
Question 6: Controlled hypotension induced during anesthesia to reduce surgical bleeding is reported with which qualifying circumstance?
- 99100
- 99116
- 99135 (Correct answer)
- 99140
Correct answer: 99135
Code 99135 is used for anesthesia complicated by utilization of controlled hypotension.
Question 7: Under the Medicare anesthesia payment formula, what does the conversion factor represent?
- The number of minutes per time unit
- The dollar amount paid per anesthesia unit (Correct answer)
- The percentage of the surgical fee paid for anesthesia
- The ratio of base units to time units
Correct answer: The dollar amount paid per anesthesia unit
The conversion factor is a dollar amount per anesthesia unit used to calculate the total anesthesia payment.
CPC Anesthesia Coding Guidelines 3
Which qualifying circumstance code is used when anesthesia is provided for a patient of extreme age, such as a neonate?