Coding, Classification and Reimbursement

is using a local considered anesthesia?

  • 1.  is using a local considered anesthesia?

    Posted 11-29-2018 12:12
    ​​Hi Everyone,
    This question came up as to using CPT 20694. In the dictation the physician states he gave the patient a local when removing an external fixation device. Would that be considered 'under anesthesia' as the description of 20694 or would the removal be included in the global period?

    Thank you for all of your help.

    Teresa Mathews
    Coding Assistant
    Premier Bone and Joint Centers

  • 2.  RE: is using a local considered anesthesia?

    Posted 11-29-2018 15:08
    No, you would not report local anesthesia as "under anesthesia".  Below is an excerpt from CPT Assistant explaining fracture care.  Hope this helps.

    For the musculoskeletal system repair services, as stated in the "CPT Surgical Package Definition" section of the Surgery guidelines, the local infiltration of medication(s), anesthetic, or contrast agent before, during, or at the conclusion of the procedure is an inclusive service, and therefore, is not separately reported as "anesthesia."

    For more information on the definitions of anesthesia services such as "general anesthesia" and "monitored anesthesia care," refer to the article, "Moderate Sedation Changes," in the June 2017 issue of CPT Assistant and the American Society of Anesthesiologists' practice guideline resource, "Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia."1

    For purposes of coding, use of local anesthetics is not considered "anesthesia." If an orthopedic injury is treated only using local anesthesia, treatment should be reported using a code that does not specify "with anesthesia."

    Allison Evans, RHIA
    Coding Manager