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Keep up with the 2022 ASA Code Changes to Bolster the Bottom Line in 2022

March 9, 2022

With changes to ASA codes often comes changes in reimbursement.  Effective on January 1, 2022, two ASA codes were deleted and replaced with six new ASA codes.

While the old codes had five base units each, four of the six new codes will only have four base units.  These six new codes are divided into procedures for the cervical/thoracic area and the lumbar/sacral area.  The types of procedures associated with each of the code sets below will help determine how this might affect your bottom line.

Deleted Codes

  • 01935 (Anesthesia for percutaneous image guided procedures on the spine and spinal cord; diagnostic with 5 Base Units)
  • 01936 (Anesthesia for percutaneous image guided procedures on the spine and spinal cord; therapeutic with 5 Base Units)

New Codes

  • 01937 – Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic (4 Base Units)
  • 01938 – Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral (4 Base Units)

Types of procedures included in 01937-01938

  • Disc aspiration procedures (including spinal cord cyst or syrinx)
    • Biopsy of spinal cord
    • Injection for myelography or CT (lumbar)
    • Injections for Discograms
    • Implantation/revision intrathecal drug catheter (without laminotomy)
    • Spinal injections (epidural injections, transforaminal injections and facet joint/medial branch blocks)**
  • 01939 – Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic (4 Base Units)
  • 01940 – Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral (4 Base Units)

Types of procedures included in 01939-01940

  • Lysis of epidural adhesions
    • Thermal destruction of intraosseous basivertebral nerve
    • Destruction of facet joint nerves
  • 01941 – Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic (5 Base Units)
  • 01942 – Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral (5 Base Units)

Types of procedures included in 01941 – 01942

  • Vertebroplasty/Kyphoplasty
  • Percutaneous intradiscal electrothermal annuloplasty
  • Injection/Infusion of neurolytic substances (alcohol, phenol, iced saline)
  • Implantation/removal/revision of percutaneous spinal cord stimulator leads
  • Percutaneous sacral augmentation (sacroplasty)
  • Percutaneous laminotomy/laminectomy
  • Percutaneous injection of allogenic cellular and/or tissue-based product into intervertebral disc

Also of note, a new nationwide LCD (Local Coverage Determination) policy was released in December 2021 for epidural injections, which included a statement that the use of moderate/deep sedation, general anesthesia, or monitored anesthesia care is usually unnecessary or rarely indicated for these procedures (epidural injections/transforaminal injections) and therefore, is not considered reasonable and necessary.  It should be noted that, even in patients with needle phobia and anxiety, typically oral anxiolytics suffice. In exceptional and unique cases, documentation must clearly establish the need for such sedation in the specific patient. Zotec Partners will continue to provide updates on 2022 ASA code changes and more.

By: Pamela Linton, CPC, CANPC, Manager, Corporate Coding

For more information or to discover other ways to positively impact your anesthesia reimbursement, contact Jeff Fowler with the Zotec anesthesiology team at jfowler@zotecpartners.com.