GI Anesthesia Code & Base Unit Changes for 2018

-->November 13, 2017Billing & Compliance Alerts

CMS published its final rules for 2018 as it relates to GI Anesthesia

Bellinger P. Moody, RHIA, CPC-I, CPC, CCP

President

Dear colleagues:

CMS published its final rules for 2018 as it relates to GI Anesthesia. The following changes were introduced: 

In accordance with the 2018 CMS Final Rule, five codes for anesthesia for gastro-endoscopic procedures have been added, and three low-volume codes have been deleted. Anesthesia practices that report codes 00740 (Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum) or 00810 (Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum) will select more detailed codes beginning January 1, 2018:

  • 5 units – 00731 (Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified).
  • 6 units – 00732 (endoscopic retrograde cholangiopancreatography [ERCP]).
  • 4 units – 00811 (Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified).
  • 3 units – 00812 (screening colonoscopy).
  • 5 units – 00813 (Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum).

The 2018 CPT book also includes these new GI anesthesia codes which means that they will apply to all payers.  Medac will perform an impact analysis on these code changes and will provide more specific details in later alerts.

Additionally:

2018 Medicare Physician Fee Schedule Increases National Anesthesia Conversion Factor

The 2018 Medicare Physician Fee Schedule provides an increase of $0.1443 in the national anesthesia conversion factor.  The current year’s (2017) national anesthesia conversion factor is $22.0454. Beginning January 1, 2018, the national anesthesia conversion factor increases to $22.1887.

The information presented herein reflects general information that is current as of the date it was first published.  In light of changes that may occur in the health care regulatory and compliance environments, the author’s presentation of this information might become outdated.  Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.