CPC Anesthesia Coding Guidelines 2 — Questions and Answers
Question 1: Which anesthesia base unit value is assigned to most nerve block procedures?
- 3 base units
- 5 base units (Correct answer)
- 7 base units
- 10 base units
Correct answer: 5 base units
Most nerve block procedures are assigned 5 base units under the ASA anesthesia relative value guide.
Question 2: What does the 'P' in the ASA Physical Status Classification P3 indicate?
- Patient is pediatric age
- Patient has severe systemic disease (Correct answer)
- Patient is pregnant
- Patient requires preoperative medication
Correct answer: Patient has severe systemic disease
ASA P3 indicates a patient with severe systemic disease that is not incapacitating, such as controlled COPD or diabetes.
Question 3: When billing anesthesia for a bilateral procedure, how are time units typically reported?
- Double the time units for each side
- Report time units only once for the total procedure time (Correct answer)
- Add 5 units per additional side
- Report each side separately with its own time units
Correct answer: Report time units only once for the total procedure time
Time units are reported once for the total anesthesia time regardless of bilateral nature of the procedure.
Question 4: Which modifier indicates that an anesthesiologist personally performed the anesthesia without a CRNA?
- AA (Correct answer)
- AD
- QK
- QZ
Correct answer: AA
Modifier AA indicates anesthesia services performed personally by an anesthesiologist.
Question 5: A patient undergoing anesthesia for a procedure on the forearm would be classified under which body area in the CPT anesthesia section?
- Head
- Upper abdomen
- Upper arm and elbow
- Lower arm, wrist, and hand (Correct answer)
Correct answer: Lower arm, wrist, and hand
The forearm is part of the lower arm region, coded under CPT codes for lower arm, wrist, and hand procedures (01810–01860).
Question 6: Which of the following best describes the 'base units' component of anesthesia billing?
- Units based on the length of the surgical procedure
- A fixed value assigned to each anesthesia CPT code reflecting complexity (Correct answer)
- Units added for each qualifying circumstance
- Units calculated from the patient's weight
Correct answer: A fixed value assigned to each anesthesia CPT code reflecting complexity
Base units are pre-assigned values in the ASA Relative Value Guide that reflect the complexity of each anesthesia service.
Question 7: What is the correct action when an anesthesia service is provided for a procedure not listed in the CPT anesthesia section?
- Use the surgical CPT code with modifier 47
- Report the closest anesthesia code with modifier 22
- Use the unlisted anesthesia code 01999 (Correct answer)
- Bill only the time units with no base code
Correct answer: Use the unlisted anesthesia code 01999
When no specific anesthesia code exists, the unlisted anesthesia procedure code 01999 should be reported.
CPC Anesthesia Coding Guidelines 2
Which anesthesia base unit value is assigned to most nerve block procedures?