Anesthesia PQRS Updates for 2014

Make sure your anesthesia coding staff checks anesthesia PQRS updates on an annual basis.

If you’re still not up to speed on the latest anesthesia coding and PQRS updates for 2014, here are some pointers to get you moving in that direction. Effective January 1, 2014, CPT® 2014 introduced two new Category II codes describing how the patient is transferred from the treatment location to the critical care unit. These CPT® codes were technically implemented on January 1, 2013 itself, but were not added to the PQRS anesthesia measurement codes during that time. These “performance measurement” codes have finally gone into effect this year. 

The new Category II codes are: 

·         0581F – Patient transferred directly from anesthetizing location to critical care unit (Peri2)

·         0582F – Patient not transferred directly from anesthetizing location to critical care unit (Peri).

                                                               

These appear to be a new Physician Quality Reporting System (PQRS) measure for anesthesia. Since anesthesia providers shift the patient to either the post-anesthesia care unit (PACU) or the crucial care unit (CCU), these PQRS codes will track how sick the patient was upon transfer of care. 

Check these four new Category II codes in place of existing Anesthesia Measure 193

Four New Category II codes appear to be a change to the existing PQRS measure 193 for anesthesia:

·         4553F – Patient received inhalation anesthetic agent (Peri2)

·         4555F – Patient did not receive inhalation anesthetic agent (Peri2)

·         4559F – At least 1 body temperature measurement equal to or greater than 35.5 degrees Celsius (or 95.9 degrees Fahrenheit) recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time (Peri2)

·         4560F – Anesthesia technique did not involve general or neuraxial anesthesia (Peri2).

Tread carefully

In 2013 when you reported postoperative temperature management, you used performance measurement codes 4250F-4256F. These codes are very similar to the new codes listed above and will still be effective in 2014. Many fail to understand why this data would be collected and reported when it is so similar to measure 193. One can only hope to get more explanation to report things accurately. 

Watch out for Hypothermia code shifts

Two Category III (temporary) hypothermia codes that were introduced in the year 2012 have moved to Category I status in 2014:

·         Temporary code 0260T (Total body systemic hypothermia, per day, in the neonate 28 days of age or younger) will become +99481 (Total body systemic hypothermia in a crucially ill neonate per day [List separately in addition to code for primary procedure])

·         Temporary code 0261T (Selective head hypothermia, per day, in the neonate 28 days of age or younger) will become +99482 (Selective head hypothermia in a critically ill neonate per day [List separately in addition to code for primary procedure]).

Pay attention: Remember that even though these codes represent controlled hypothermia, they are not meant for anesthesia providers.  Qualifying circumstances codes for hypothermia are used unless it is already included in the base value of the anesthesia code.

To get more PQRS and anesthesia coding updates on a regular basis, rely on a practical, how-to anesthesia coding resource like SuperCoder Anesthesia Coding Alert.