Effective December 19, 2008, we have updated our reporting requirements for anesthesia services performed by providers in anesthesia specialties for a cancelled or discontinued procedure.

The following requirements are also available in policy #01.00.02b, Anesthesia Services for a Cancelled or Discontinued Procedure.

• If the procedure is cancelled due to the assessment of the patient’s condition during the anesthesia provider’s presurgical/preanesthetic evaluation and before induction of regional or general anesthesia:
  −− Report an evaluation and management (E&M) code that reflects the type and level of service performed.
  Note: We apply CPT® (Current Procedural Terminology) E&M service reporting guidelines that are current on the date of service to all E&M (e.g., consultation E&M) codes.
• If the procedure is cancelled following the anesthesia provider’s presurgical/preanesthetic assessment and the patient’s preparation for surgery, and before induction of regional or general anesthesia:
  −− Report CPT code 01999.
• If the procedure is cancelled or discontinued after general or regional anesthesia induction has occurred:
  −− Report the appropriate anesthesia (ASA) code corresponding to the surgical procedure plus the time, in minutes, expended providing the anesthesia services.
  Note: If reimbursement for the ASA code is considered by the Company at a flat rate, time is not applied and should not be reported. Individual provider fee schedules apply.

• The primary diagnosis(es) and, as a secondary diagnosis, either V64.1 or V64.3 are necessary to identify that the procedure was cancelled or discontinued.
• A description of and an indication that the procedure was cancelled or discontinued are required.
• Providers must not report base units in association with anesthesia services.