Notification

Reporting and Documentation Requirements for Anesthesia Services


Notification Issue Date: 01/22/2020



Policy Attachment



Attachment to Policy # 00.01.14r


Attachment:A

Policy #:00.01.14r

Description:ASA Anesthesia Procedure Codes

Title:Reporting and Documentation Requirements for Anesthesia Services


Inclusion of a code in this table does not imply reimbursement. Eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.

The codes listed below are updated on a regular basis, in accordance with nationally accepted coding guidelines. Therefore, this policy applies to any and all future applicable coding changes, revisions, or updates.

In order to ensure optimal reimbursement, all health care services, devices, and pharmaceuticals should be reported using the billing codes and modifiers that most accurately represent the services rendered, unless otherwise directed by the Company.


AMERICAN SOCIETY OF ANESTHESIOLOGISTS (ASA) ANESTHESIA PROCEDURE CODES

This policy attachment lists the ASA anesthesia procedure codes. Refer to the Coding Table in the policy for lists of other anesthesia service codes and modifiers.

CODE
00100
00102
00103
00104
00120
00124
00126
00140
00142
00144
00145
00147
00148
00160
00162
00164
00170
00172
00174
00176
00190
00192
00210
00211
00212
00214
00215
00216
00218
00220
00222
00300
00320
00322
00326
00350
00352
00400
00402
00404
00406
00410
00450
00454
00470
00472
00474
00500
00520
00522
00524
00528
00529
00530
00532
00534
00537
00539
00540
00541
00542
00546
00548
00550
00560
00561
00562
00563
00566
00567
00580
00600
00604
00620
00625
00626
00630
00632
00635
00640
00670
00700
00702
00730
00731
00732
00750
00752
00754
00756
00770
00790
00792
00794
00796
00797
00800
00802
00811
00812
00813
00820
00830
00832
00834
00836
00840
00842
00844
00846
00848
00851
00860
00862
00864
00865
00866
00868
00870
00872
00873
00880
00882
00902
00904
00906
00908
00910
00912
00914
00916
00918
00920
00921
00922
00924
00926
00928
00930
00932
00934
00936
00938
00940
00942
00944
00948
00950
00952
CODE
01112
01120
01130
01140
01150
01160
01170
01173
01200
01202
01210
01212
01214
01215
01220
01230
01232
01234
01250
01260
01270
01272
01274
01320
01340
01360
01380
01382
01390
01392
01400
01402
01404
01420
01430
01432
01440
01442
01444
01462
01464
01470
01472
01474
01480
01482
01484
01486
01490
01500
01502
01520
01522
01610
01620
01622
01630
01634
01636
01638
01650
01652
01654
01656
01670
01680
01710
01712
01714
01716
01730
01732
01740
01742
01744
01756
01758
01760
01770
01772
01780
01782
01810
01820
01829
01830
01832
01840
01842
01844
01850
01852
01860
01916
01920
01922
01924
01925
01926
01930
01931
01932
01933
01935
01936
01951
01952
01953
01958
01960
01961
01962
01963
01965
01966
01967
01968
01969
01990
01991
01992
01996
01999



Version Effective Date: 04/20/2020
Version Issued Date: 04/20/2020
Version Reissued Date: N/A



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