The following are changes for 2015 that affect the way procedures will be coded and reported with ASA and the base units.

Implantable cardioverter-defibrillator

The first change is for Implantable cardioverter-defibrillator (ICD) procedures when performed with testing. The 2015 ASA Relative Value Guide (RVG®)Coding Comments were revised for the following ASA codes:

ASA changes 1

As a result, many of the ASA Crosswalk® options available for surgical CPT codes reported for ICD procedures, including electrophysiologic testing of the device, have changed from ASA code 00537 (10 base units ) to 00534 (7 base units) which will result in a loss of 3 base units when these types of procedures are performed.

Cystourethroscopy with ureteroscopy and/or pyeloscopy

Another important change that resulted in a loss of units was for Cystourethroscopy with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus, lithotripsy, or biopsy/fulguration, or resection of ureteral or renal pelvic lesions/tumors.

The 2015 ASA Crosswalk removed the crosswalk options that gave an option for an alternate ASA 00862 if the procedure involved the upper 1/3 of the ureter, renal pelvis or kidney that resulted in a loss of 2-4 base units.

 ASA changes 2

ASA changes 3

ASA changes 4

Pacemaker/Cardioverter-defibrillator procedures

The following CPT Procedures for Pacemaker/Cardioverter-defibrillator procedures cross to the primary ASA cross of 00534 (7 base units) [Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator], however there is no alternate this year.

 ASA changes 5

The following CPT all cross to the primary ASA 00534. The alternate of 00400 is to be used when there is no testing. Therefore, if testing is not documented additional information will be needed. 

 ASA changes 6

Resources:
American Society of Anesthesiologists 2015 Relative Value Guide- A guide for Anesthesia Values Professional Practice Series
AMA 2015 CPT current procedural terminology

Author - Female

About the author

Mary Jo Gross, CPC, CANPC of Compliance – Anesthesia and Pain Management, McKesson Business Performance Services