CPC - Certified Professional Coder Anesthesia Coding and Modifiers Questions and Answers 1 — Questions and Answers
Question 1: A 72-year-old patient with well-controlled hypertension undergoes a cholecystectomy. What is the appropriate physical status modifier to append to the anesthesia code?
- P1
- P2 (Correct answer)
- P3
- P4
Correct answer: P2
The physical status modifier P2 is used for a patient with mild systemic disease. Well-controlled hypertension is considered a mild systemic disease. P1 is for a normal healthy patient, P3 is for a patient with severe systemic disease, and P4 is for a patient with a severe systemic disease that is a constant threat to life.
Question 2: An anesthesiologist begins preparing a patient for anesthesia in the operating room at 08:00. The surgical procedure starts at 08:30 and finishes at 10:00. The anesthesiologist safely transfers the patient to the post-anesthesia care unit (PACU) at 10:15. What is the total anesthesia time that should be reported in minutes?
- 135 minutes (Correct answer)
- 90 minutes
- 120 minutes
- 105 minutes
Correct answer: 135 minutes
According to CPT guidelines, anesthesia time begins when the anesthesiologist starts preparing the patient for anesthesia and ends when the anesthesiologist is no longer in personal attendance, which occurs when the patient is safely placed under postoperative care. Therefore, the total time is calculated from 08:00 to 10:15, which equals 135 minutes.
Question 3: Which of the following is an add-on code used to report anesthesia complicated by the utilization of total body hypothermia?
- +99100
- +99140
- +99116 (Correct answer)
- +99135
Correct answer: +99116
CPT code +99116 is the correct add-on code for anesthesia complicated by the utilization of total body hypothermia. Code +99100 is for extreme age, +99135 is for controlled hypotension, and +99140 is for emergency conditions.
Question 4: Which modifier should be used by an anesthesiologist to report the medical direction of two, three, or four concurrent anesthesia procedures?
- AA
- AD
- QY
- QK (Correct answer)
Correct answer: QK
Modifier QK is appended to the anesthesiologist's service to indicate they were medically directing two, three, or four concurrent anesthesia procedures. Modifier AA is for personally performed services, QY is for medical direction of one CRNA, and AD is for medical supervision of more than four concurrent procedures.
Question 5: A Certified Registered Nurse Anesthetist (CRNA) provides anesthesia services under the medical direction of an anesthesiologist for a single case. Which modifiers should be reported by the CRNA and the anesthesiologist, respectively?
- QZ, AA
- QX, QY (Correct answer)
- QK, QX
- QZ, QK
Correct answer: QX, QY
When a CRNA provides service with medical direction from a physician, the CRNA reports modifier QX. When an anesthesiologist medically directs a single CRNA, the anesthesiologist reports modifier QY. Therefore, the correct combination is QX for the CRNA and QY for the anesthesiologist.
Question 6: In the standard formula for anesthesia reimbursement (Base Units + Time Units + Modifying Units) x Conversion Factor, what do the base units for an anesthesia CPT code represent?
- The total time in 15-minute increments the patient was under anesthesia.
- The additional value assigned for the patient's physical health status (P1-P6).
- The complexity, skill, and work intensity of the anesthesia service before time is considered. (Correct answer)
- A geographic adjustment factor based on the location of the service.
Correct answer: The complexity, skill, and work intensity of the anesthesia service before time is considered.
Base units are pre-assigned to each anesthesia CPT code and reflect the relative complexity and work involved in the anesthesia service for a specific surgical procedure, including usual pre-operative and post-operative care. Time units, physical status modifiers, and the conversion factor are separate components of the reimbursement formula.
CPC - Certified Professional Coder Anesthesia Coding and Modifiers Questions and Answers 1
A 72-year-old patient with well-controlled hypertension undergoes a cholecystectomy.
What is the appropriate physical status modifier to append to the anesthesia code?