Anesthesia Coding Alert Your practical adviser for ethically optimizing coding, payment, and efficiency for anesthesia practices

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1 The Coding Institute SPECIALTY ALERTS CodingInstitute.com; SuperCoder.com Inspired by Coders, Powered by Coding Experts Anesthesia Coding Alert Your practical adviser for ethically optimizing coding, payment, and efficiency for anesthesia practices December 2011, Vol. 13, No. 12 (Pages 81-88) In this issue Post-Procedure Care Manage Your Reporting Correctly: Real World Scenarios Show You How p82 LCDs and other resources to help you determine when is legit. News Flash Modifier AA Could Bring You Extra Pay for CAH Services in 2012 p83 Check the updated guidelines if you bill anesthesia services on behalf of a critical access hospital. ICD-10 New K38 Choices Will Expand Appendicitis Specificity Watch for other versus unspecified options. You Be the Coder Deciding Time Between CRNA and Anesthesiologist Reader Questions p84 p84 Only Report With in Special Circumstances p85 Include AD for Maxed Concurrent Cases p85 Patient s Position Determines or p85 Placement Clues You to Central Line With Swan-Ganz p86 Keep or to Single Unit, Not Bilateral p86 Intent Helps Distinguish SI Injection From Arthrogram p86 Turn to Q5 for Vacation-Coverage Billing p87 CPT 2012 } 62310, Revisions Help Clarify Your Single Shot vs. Indwelling Catheter Coding Plus: Prepare for changes to 77003, too. Although you won t report new or revised CPT codes until January 2012, prepare yourself and your anesthesia providers now for revisions that can affect your everyday coding, such as the rewording of two popular epidural codes. Examine the Descriptor Differences The primary changes apply to epidural codes and The current and upcoming descriptors are as follows: Code Current Descriptor Revised Descriptor (effective Jan. 1, 2012) Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localization or epidurography)(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opiod, steroid, other solution), epidural or subarachnoid; cervical or thoracic Injection(s), including catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opiod, steroid, other solution), epidural or subarachnoid; cervical or thoracic The new descriptors incorporate several changes: Injection(s) of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opiod, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opiod, steroid, other solution), not including neurolytic substances, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic clarifies that it can be used for more than one single injection no longer mentions the possible use for epidurography. Epidurography is a separate procedure that doesn t need to be related to this code, explains coding consultant Samantha Fowler, CPC, CPC-I, MCS-P, ACS-AN. The current version of doesn t include catheter administration, but the revised descriptor does. Physicians were placing catheters for single shots and trying to bill or 62311, Fowler explains. The difference is that one pair of codes is for 2011 Call us: The Coding Institute, LLC 2222 Sedwick Drive, Durham, NC 27713

2 The Coding Institute SPECIALTY ALERTS Call us: The Coding Institute, LLC 2222 Sedwick Drive, Durham, NC Editorial Advisory Board Lee S. Broadston President/CEO, BCS Inc., Minn. Patrick Cafferty, PA-C, MPAS Member, AMA Health Care President/CEO, Neurosurgical Associates of Western Kentucky Barbara J. Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P, CPC-I, CHCC President, CRN Healthcare Solutions, Tinton Falls, N.J. Quita W. Edwards, CPC, CCS-P, COSC, CPC-I CEO, Practice Dynamics Macon, GA David Fugate, MS Executive Director Anesthesia Associates of Ann Arbor PC Leisa T. Gonnella, MHA Director of Administration Department of Anesthesiology University of Virginia Scott B. Groudine, MD Chair, Government, Legal and Economic Affairs Committee of the New York Anesthesia Society Professor of Anesthesiology Albany Medical Center, N.Y. Barbara J. Johnson, CPC, MPC Loma Linda University Anesthesiology Medical Group Inc. President, Real Code Inc., Calif. Janet McDiarmid, CMM, CPC, MPC CEO, McDiarmid Consultants LLC Past President American Academy of Professional Coders National Advisory Board Cindy Parman, CPC, CPC-H, RCC Principal and Co-Founder Coding Strategies Inc., Ga. AAPC National Advisory Board member Faculty Instructor, AMA Solutions Franz Ritucci, MD, DABAM, FAEP President, American Board of Ambulatory Medicine, Fla. Director, American Academy of Ambulatory Care, Fla. Lynn R. Rogers Office Manager Professional Economics Ltd., Ind. Member, Healthcare Billing and Management Association Teresa Ruiz-Law Independent Consultant Physician Groups Ltd., Ill. Susan L. Turney, MD, FACP Medical Director Reimbursement Marshfield Clinic, Wis. Linda R. Williams, CRNA, JD Past President, American Association of Nurse Anesthetists Attorney-at-Law and Medical-Legal Consultant continuous or intermittent bolus (62318/62319) and the other is for a single dose at a time (62310/62311), irregardless of catheter use. The revised specifies indwelling catheter and changes from injection to injections. Also note: Codes and now read lumbar or sacral (caudal) instead of lumbar; sacral (caudal). Don t Miss Fluoro and Nerve Destruction Changes If you sometimes report (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, subarachnoid, or sacroiliac joint], including neurolytic agent destruction) in conjunction with diagnostic or therapeutic injections, be sure to note the descriptor change, come January. The new descriptor will read Fluoroscopic guidance and localization or needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid). Change: The code no longer includes guidance for sacroiliac joint injections or neurolytic agent destruction. Replacements: Codes for paravertebral facet joint nerve destruction have been deleted and replaced with four new codes: Destruction by neurolytic agent, paravertebral facet joint nerve(s) with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure) lumbar or sacral, single facet joint lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure). Watch for more details about these changes and how they might affect your coding in future issues of Anesthesia Coding Alert. q Post-Procedure Care } Manage Your Reporting Correctly: Real World Scenarios Show You How LCDs and other resources to help you determine when is legit. The descriptor for (Daily hospital management of epidural or subarachnoid continuous drug administration) seems simple enough on the surface, but can get Anesthesia Coding Alert (USPS # ) (ISSN X for print; ISSN for online) is published monthly 12 times per year by The Coding Institute, LLC 2222 Sedwick Drive, Durham, NC The Coding Institute. All rights reserved. Subscription price is $249. Periodicals postage is paid at Durham, NC and additional entry offices. POSTMASTER: Send address changes to Anesthesia Coding Alert, 2222 Sedwick Drive, Durham, NC p82

3 Call us: The Coding Institute, LLC 2222 Sedwick Drive, Durham, NC The Coding Institute SPECIALTY ALERTS complicated in real-life coding. Read on for three scenarios from the Coding 911 listserv and our experts answers on how to handle each situation. Global Periods Help Steer Your Usage Scenario 1: Our physician recently inserted an intrathecal pump, which is a three-day inpatient stay. We code the implant on the first day, but need to use a code for daily management of the intrathecal pump on the second and third days. We used to report 01996, but recently started having problems getting it paid. Medicare also says is inclusive to the stay. How do we handle this? (Submitted by Karen Went, Connecticut Paincare) Solution: Start by verifying the global period for the service you re potentially coding. Code (Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy) has a 10-day global period. If the pain management specialist is performing 62350, then all services related to the catheter in the 10-day period following are included in the initial fee, says Diane Crosthwaite, CPC, CANPC, coding manager for abeo, Inc., Western Division, in Pasadena, Cal. Watch LCDs for State-Specific Directions Scenario 2: The physician sees a patient on the hospital floor and provides epidural catheter placement and management on separate days. The documentation is a limited handwritten progress note in the chart. The coder must determine whether the note is adequate documentation and needs suggestions on how to talk with the physician about better documentation in the future. (Submitted by a Massachusetts subscriber) Solution: Check the LCD for in your state, advises Crosthwaite. The documentation requirements should be listed there, and you can forward that to your physician since they often want to see things in writing. Tip: If your state doesn t have an LCD for 01996, check other areas. For example, Massachusetts doesn t have an LCD for National Government Services, Inc., in Indiana, however, does. The policy outlines appropriate diagnoses associated with when reporting epidural or intrathecal injections for acute post-operative pain management or for intrathecal Baclofen administration. Additional notes offer guidance for using specific diagnoses correctly. Check for Services on Removal Day Scenario 3: When is it appropriate to bill for the last day of management and catheter removal? We re divided between using or (Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components ) because no bolus is given, but the documentation doesn t meet the E/M requirements. (Submitted by a California subscriber) Solution: Billing on the day of catheter removal depends on whether the physician provides any other services for the patient that day. If the physician removes the catheter and doesn t provide any other services, do not report an additional charge (catheter removal is an expected service). If your physician provides other services and makes the decision to remove the catheter the following day, you can report for the day of services but not the day of removal. q News Flash } Modifier AA Could Bring You Extra Pay for CAH Services in 2012 Check the updated guidelines if you bill anesthesia services on behalf of a critical access hospital. If you bill anesthesia services on behalf of the provider through a Method II critical access hospital (CAH), your bottom line could improve starting in January Background: Anesthesiologists who provide services in a Method II CAH (sometimes referred to as CAHs that have elected the optional method) have the option of reassigning their billing rights to the CAH. The CAH then submits a bill with revenue code 0963 (Professional fees for anesthesiologist [MD]) to receive pay for anesthesia services. When the service is reported with modifier AA (Anesthesia services performed personally by anesthesiologist), CMS currently calculates pay based on a 20 percent reduction of the fee schedule amount before calculating deductible and coinsurance. (Continued on next page) p83

4 The Coding Institute SPECIALTY ALERTS Call us: The Coding Institute, LLC 2222 Sedwick Drive, Durham, NC Change: CMS transmittal 2268 dated August 1, 2011, removes the 20 percent reduction when calculating payment for these services. The change takes effect January 3, Supporting information with the transmittal explains that when a medically necessary anesthesia service is furnished within a HPSA [health professional shortage area] area by a physician, a HPSA bonus is payable. Pay physicians the HPSA bonus when CPT codes through are billed with the following modifiers: QY, QK, AA, or GC and QB or QU in revenue code 963. Translation: Expect the following payment levels once the change is implemented, depending on the circumstances and modifier reported: Modifier AA results in physician payment at 100% of the allowed amount. Modifier GC (This service has been performed in part by a resident under the direction of a teaching physician) results in physician payment at 80% of the allowed amount. Modifiers QK (Medical direction of two, three or four concurrent anesthesia procedures involving qualified individuals) and QY (Medical direction of one certified registered nurse anesthetist [CRNA] by an anesthesiologist) result in physician payment at 50% of the allowed amount. Details: Read the full details in the CMS Medicare Claims Processing Manual, Chapter 4, Section , Physician rendering anesthesia in a hospital outpatient setting. q ICD-10 } New K38 Choices Will Expand Appendicitis Specificity Watch for other versus unspecified options. When your anesthesiologist participates in an appendix surgery, you ll have more specific diagnosis code choices for appendix removal under ICD-10, effective Oct. 1, Separate Other From Unspecified Coding for acute appendicitis will change as follows, from ICD-9 to ICD-10: Acute appendicitis with generalized peritonitis becomes K35.2 with an identical definition You Be the Coder Deciding Time Between CRNA and Anesthesiologist A non-medically directed CRNA took the patient into the operating room. He placed the patient on monitors, intubated, and induced the patient. Then the anesthesiologist came into the room and placed an arterial line and CVP before the case started. How do we calculate the time the physician took to place the lines? New Mexico Subscriber See page 87. q Acute appendicitis with peritoneal abscess becomes K35.3 (Acute appendicitis with localized peritonitis) Acute appendicitis without peritonitis leads to two possible ICD-10 codes: K35.80 (Unspecified acute appendicitis) or K35.89 (Other acute appendicitis). ICD-10 introduces a similar distinction between other and unspecified for 541 (Appendicitis unqualified), which crosswalks to K37 (Unspecified appendicitis) and 542 (Other appendicitis), which crosswalks to K36 (Other appendicitis). Find More Choices for Other Appendix Conditions Although you ll find a one-to-one crosswalk for appendix hyperplasia (543.0, Hyperplasia of appendix [lymphoid] to K38.0, Hyperplasia of appendix), ICD-10 provides many more specific codes for other conditions. Instead of ICD-9 s catch-all code (Other and unspecified diseases of appendix), you ll choose one of the following diagnoses under ICD-10: K38.1 Appendicular concretions K38.2 Diverticulum of appendix K38.3 Fistula of appendix K38.8 Other specified diseases of appendix K38.9 Disease of appendix, unspecified. p84

5 Call us: The Coding Institute, LLC 2222 Sedwick Drive, Durham, NC The Coding Institute SPECIALTY ALERTS With all the new choices, working under ICD-10 makes checking both the anesthesia and surgical reports even more important than it is today. The more details you can extract Reader Questions } Only Report With in Special Circumstances Our pain management physician sometimes performs a hip arthrogram and hip injection during the same patient encounter. Can we bill both services? Vermont Subscriber The codes in question include (Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]), (Injection procedure for hip arthrography; without anesthesia), and (Radiologic examination, hip, arthrography, radiological supervision and interpretation). Current CCI edits list as a Column 2 code of 27093, which means you shouldn t normally report both procedures together if the physician performs the arthrogram and injection on the same hip. The bundle does allow you to report a modifier, however, to differentiate between services in some instances. Check your documentation to determine whether a modifier such as 59 (Distinct procedural service) might be justified. If you can t report both and for the encounter, submit only with q Include AD for Maxed Concurrent Cases What are the current Medicare rules when our anesthesiologist bills more than four concurrent cases? Do we reduce the units, or does Medicare? South Carolina Subscriber Always include modifier AD (Medical supervision by a physician; more than 4 concurrent anesthesia procedures) with each claim when the anesthesiologist reports more than four concurrent cases. Units drop: Carriers may allow only three base units per procedure when the anesthesiologist is involved in more than four procedures concurrently or performs other services from the reports, the more likely you ll be to choose the most appropriate diagnosis. q while directing the concurrent procedures. The carrier might recognize an additional time unit if the physician can document that he or she was present at induction. CMS has previously clarified that the carrier should allow three base units plus one time unit if the physician is present at induction (and reports the AD modifier). Details: Check your local guidelines for specific instructions and know that Medicare will reduce the units for you when applicable you don t need to do it yourself. If you employ the CRNA, be sure to append a QX modifier (CRNA service: with medical direction by a physician) to report their services and verify that documentation supports the medical direction requirements. q Patient s Position Determines or Our anesthesiologist sometimes performs anesthesia for a pain management physician. In a recent procedure, the pain management specialist performed (Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level) and ( cervical or thoracic, each additional level [List separately in addition to code for primary procedure]). How should I code our anesthesiologist s involvement? North Dakota Subscriber The anesthesia codes correspond to the patient s position at the time of the injection, so knowing his or her position will lead you to the correct code: If the patient was placed on his stomach or in the prone position during the procedure, report (Anesthesia for diagnostic or therapeutic nerve blocks and injections [when block or injection is performed by a different provider]; prone position). If he was in any other position the position was other than prone that is, sitting up or lying on his back or side use ( other than the prone position). Don t forget: CPT states that you cannot report or with (Moderate sedation services...). q p85

6 The Coding Institute SPECIALTY ALERTS Call us: The Coding Institute, LLC 2222 Sedwick Drive, Durham, NC Placement Clues You to Central Line With Swan-Ganz Our anesthesiologist recently documented that we should code for a central line, arterial line, and Swan-Ganz catheter during a procedure. It s been a long time since one of our physicians marked all three for a single case; what s the current rule regarding line coding? Mississippi Subscriber You can bill the arterial line with (Arterial catheterization or cannulation for sampling, monitoring, or transfusion [separate procedure]; percutaneous). The central line (36556, Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older) is included in the Swan-Ganz (93503, Insertion and placement of flow directed catheter [e.g., Swan-Ganz] for monitoring purposes) fee when your physician uses both, which means you won t normally code for both. Exception: You can report both lines if your anesthesiologist documents separate locations and placements for the central line and Swan-Ganz catheter. Otherwise, you ll code with and q Keep or to Single Unit, Not Bilateral When our physicians administer Botox for chronic migraines, we bill the HCPCS J code for the drug with procedure code and modifier 50. Payers are sending multiple denials, stating that the procedure/modifier combination is invalid. What s our best coding strategy? Texas Subscriber When billing injections of Botulinum toxins, aka chemodenervation, the key is to review the CPT code terminology. The procedure code you ll turn to is (Chemodenervation of muscle[s]; neck muscle[s] [e.g., for spasmodic torticollis, spasmodic dysphonia]). Note that the descriptor states, muscle(s). Regardless of the number of injections your provider administers to the same muscle area, you should only report the applicable chemodenervation code once. Report J0585 (Injection, onabotulinumtoxina, 1 unit) for the medication. Remember most payers allow coverage for unavoidable wastage of single dose medications, including Botulinum toxins. It is important that your provider clearly documents both the amount injected and wasted. Some payers require the wastage to be reported on a separate line item with modifier JW (Medication discarded as waste). It is best to check your payer s policy before filing the claim. Change: In the past, Medicare allowed you to report bilateral instances of or ( ; extremity(s) and/or trunk muscle(s) (eg, for dystonia, cerebral palsy, multiple sclerosis) on the same claim by appending modifier 50 (Bilateral procedure). Effective April 1, 2011, Medicare changed the billing rules, however. The Physician Fee Schedule currently shows a modifier indicator of 0, meaning you cannot bill these codes bilaterally. The exception to the rule is (Chemodenervation of muscle(s); muscle(s) innervated by facial nerve (e.g., for blepharospasm, hemifacial spasm); if the physician injects the muscles around both eyes, you can append modifier 50 to and be paid accordingly. q Intent Helps Distinguish SI Injection From Arthrogram What is the difference between a sacroiliac (SI) joint injection and an SI joint arthrogram? How do I know the difference when requesting authorization prior to the procedure being rendered? South Carolina Subscriber An arthrogram requires a formal radiological interpretation and report that the physician uses for further diagnosis and treatment of the patient. It also requires that hard copies of multiple views of the arthrogram be obtained. In contrast, the Are You Prepared for Upcoming Coding Changes? Join Audio Conferences by Industry Experts on 2012 Coding Updates! There will be 278 new, 139 revised, 98 deleted and 22 resequenced CPT codes in Make plans to attend our audio conferences provided by our panel of coding veterans and experts this December, in order to keep up with these changes. Here s what you ll learn: Which updates and guidelines affect your coding and reimbursement in 2012 Examples of how to apply CPT changes affecting your specialty What documentation payers expect you to provide for full reimbursement To find the audio conference for your specialty(s), log on to com/2012-coding-updates today! Book any conference within 07 days to get $25 discount. Enter Discount Code PUB25 at check-out! Audio Educator, 2222 Sedwick Drive, Durham, NC customerservice@audioeducator.com Call to save on multiple updates! p86

7 Call us: The Coding Institute, LLC 2222 Sedwick Drive, Durham, NC The Coding Institute SPECIALTY ALERTS fluoroscopic guidance used with a diagnostic and/or therapeutic SI joint injection is used solely for confirming that the needle was accurately placed within the joint capsule; which is far more commonly performed. The Instructions for Use of the CPT Codebook directs providers that Reports are the work product of the interpretation of test results. Certain procedures or services described in CPT involve a technical component (e.g., tests) that produce results (e.g., data, images, slides) Some CPT descriptors specifically require interpretation and reporting to report that code. Coders can sometimes be confused by the injection of contrast during an SI joint injection procedure. Some physicians comment more than others about what they see once the contrast is within or around the joint, but that doesn t automatically point to an arthrogram. Even with fluoroscopy and a detailed description, the intent of the procedure is the SI joint injection rather than primarily a diagnostic radiologic study. Additionally, the physician won t complete a separate, formal radiological interpretation. Your coding will change, depending on whether the physician completes a joint injection or arthrogram. You Be the Coder Deciding Time Between CRNA and Anesthesiologist (Question on page 84) Deduct the time spent placing the arterial line and CVP from the total anesthesia time, and bill the lines under the physician s ID. For example, you might submit (Arterial catheterization or cannulation for sampling, monitoring or transfusion [separate procedure]; percutaneous) for the arterial line and (Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older) for the CVP on the anesthesiologist s claim. Bill the other services under the CRNA. Include modifier QZ (CRNA service: without medical direction by a physician) to indicate he was not medically directed during the case. The chart should note how long it took the anesthesiologist to place the lines. Deduct this time from the total anesthesia time for the entire procedure, so you can calculate the correct number of time units for the CRNA. q For an SI joint injection, submit (Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid) with (Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures [epidural, subarachnoid, or sacroiliac joint], including neurolytic agent destruction). For an SI joint arthrogram, report with (Radiological examination, sacroiliac joint arthrography, radiological supervision and interpretation). q Turn to Q5 for Vacation-Coverage Billing One physician from our group covered another physician s days while he went on vacation. Whose name should appear on the claim? Florida Subscriber You may submit the claim in the vacationing physician s name and receive payment, according to section of Chapter 1 of the Medicare Claims Processing Manual ( gov/manuals/downloads/clm104c01.pdf). There are, of course, several conditions the visit must meet, which you can read about in the manual. One condition you want to be sure to meet as a biller is that you must append modifier Q5 (Service furnished by a substitute physician under a reciprocal billing arrangement) to the code for the procedure the substitute physician provides. Group billing: If your group submits claims under a group ID, be sure to read the sections specific to that circumstance. For example, the manual explains that On claims submitted by the group, the group physician who actually performed the service must be identified. The exception is that When a group member provides services on behalf of another group member who is the designated attending physician for a hospice patient, the Q5 modifier may be used by the designated attending physician to bill for services related to a hospice patient s terminal illness that were performed by another group member. If the physicians in your group bill in their own names, treat them the same as independent physicians under the Medicare reciprocal billing rules. Details: Be sure to keep a log or record of the vacationing and replacement physician. q Answers to You Be the Coder and Reader Questions were provided by Kelly Dennis, MBA, ACSAN, CANPC, CHCA, CPC, CPC-I, president of Perfect Office Solutions in Leesburg, Fla. p87

8 The Coding Institute SPECIALTY ALERTS Call us: The Coding Institute, LLC 2222 Sedwick Drive, Durham, NC CodingInstitute.com; SuperCoder.com Inspired by Coders, Powered by Coding Experts Anesthesia C O D I N G A L E R T Mary Compton, PhD, CPC maryc@codinginstitute.com Editorial Director and Publisher We would love to hear from you. Please send your comments, questions, tips, cases, and suggestions for articles related to Anesthesia coding and reimbursement to the Editor indicated below. The Coding Institute, LLC 2222 Sedwick Drive, Durham, NC Tel: Fax: (800) service@codinginstitute.com Anesthesia Coding Alert is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional services. If legal advice or other expert assistance is required, the services of a competent professional should be sought. CPT codes, descriptions, and material only are copyright 2011 American Medical Association. All rights reserved. No fee schedules, basic units, relative value units, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to governement use. Rates: USA: 1 yr. $249. Bulk pricing available upon request. Contact Medallion Specialist Team at medallion@codinginstitute.com. Credit Cards Accepted: Visa, MasterCard, American Express, Discover This publication has the prior approval of the American Academy of Professional Coders for 0.5 Continuing Education Units. Granting of this approval in no way consitutes endorsement by the Academy of the content. Log onto Supercoder.com/membersarea to access CEU quiz. To request log in information, customerservice@supercoder.com Part B (Multispecialty) Billing & Collections Cardiology Dermatology Emergency Medicine Family Medicine Gastroenterology General Surgery Health Information Compliance Internal Medicine Neurology & Pain Management Leigh DeLozier leighd@codinginstitute.com Editor Jennifer Godreau, CPC, CPMA, CPEDC jenniferg@codinginstitute.com Content Director Kelly Dennis, MBA, ACSAN, CANPC, CHCA, CPC, CPC-I Consulting Editor The Coding Institute also publishes the following specialty content both online and in print. Call for a free sample of any or all of the specialties below: Neurosurgery Ob-Gyn Oncology & Hematology Ophthalmology Optometry Orthopedics Otolaryngology Pathology/Lab Pediatrics Physical Medicine & Rehabilitation Podiatry Suzanne Leder, BA, MPhil, CPC, COBGC suzannel@codinginstitute.com Executive Editor Pulmonology Radiology Rehab Report Urology Announcing Supercoder, the online coding wiz. Call us ( ) with your customer number for a special price, free trial, or just to find out more. Order or Renew Your Subscription! Yes! Enter my: one-year subscription (12 issues) to Anesthesia Coding Alert for just $249. Extend! I already subscribe. Extend my subscription for one year for just $249. Subscription Version Options: (check one) Print Online* Both*(Add online to print subscription FREE) * Must provide address if you choose online or both option to receive issue notifications Name Title Company Address City, State, ZIP Phone Fax To help us serve you better, please provide all requested information Payment Options Charge my: MasterCard VISA AMEX Discover Card # Exp. Date: / / Signature: Check enclosed (Make payable to The Coding Institute) Bill me (please add $15 processing fee for all billed orders) Anesthesia Coding Alert The Coding Institute PO Box Atlanta, GA Call Fax (801) service@codinginstitute.com SuperCoder is a property of CodingInstitute.com p88