anesthesia cpt coding 2017
TRANSCRIPT
ANESTHESIA
INTRODUCTION DEFINITION: loss of sensation TYPES: General anesthesia
Retinol anesthesiaLocal anesthesia
Anesthesia may induce temporary loss of sensation or awareness
It may categorized as :- analgesia (relief from or prevention
of pain) paralysis(muscle relaxation) amnesia (loss of memory)
or unconsciousness.
A patient under the effects of anesthetic drugs is referred to as being anesthetized.
General anesthesia suppresses central nervous system.
Regional anesthesia and local anesthesia, which block transmission of nerve impulses between a targeted part of the body.
MEDCINAL USESMAIN PURPOSE OF ANESTHESIA Hypnosis (temporary loss of
consciousness) Analgesia(lack of sensation) muscle relaxation
General anesthetics can affect all of the endpoints.
Whereas local/regional anesthetics affect the endpoints differently.
OBJECTIVES OF ANESTHESIA Unconsciousness Amnesia Analgesia Oxygenation Ventilation Homeostatic Air management Reflex management Muscle relaxation monitoring
TREATMENT INTRAVENOUS DRUGS:- Thiopentone Propofol Others like:-
etomidate,benzodiazepines,ketamine.
INHALATIONAL DRUGS:- NITROUS OXIDE ISOFLURANE SEVOFLURANE DESFLURANE HALOTHANE
ANALGESIC CLASS:- Opiates Local anesthetics like:NSAIDS,
Paracetamol. Opiate analgesics
like:morphine,codeine. NSAIDS ANALGESIC:- Ibuprofen Diclofenac Cox-2 inhibitors
Muscle relaxant anesthesia drugs like:- Suxmethonium Tracurium LOCAL ANESTHESIA
ex:lignocaine,bupivacaine, prilocaine
ADVANTAGES OF LOCAL ANESTHESIA Effective alternative to general
anesthesia Avoids polypharmacy Allergic reactions Patient can remain awake
DISADVANTAGES OF LOCAL ANESTHESIA LIMITED SCOPE HIGHER FAILURE RATE RISK OF NEURAL INJURY
ANESTHESIA CODING In coding it classified as:- Spinal anesthesia Epidural anesthesia Nerve block anesthesia Time of anesthesia is calculated in units Each 15 minutes=I unit
TIME REPORT FOR ANESTHESIA Time starts from preparing the patient
for the induction of anesthesia in OP room and ends when the patient may be safely placed under postoperative supervision
Depending upon the type of services codes are listed in E/M services
special services are listed in medicine
Multiple procedures under single anesthetic administration code represents most complex procedure.
Range of anesthesia code 00100-01999 plus addition of physical state modifier.
The use of other optional modifiers may be appropriate
PHYSICAL STATUS MODIFIERS Based on (ASA) P1:a normal healthy patient P2 :a patient with mild systemic disease P3:a patient with severe systemic disease P4:a patient with severe systemic disease
that is a constant threat to life P5:a moribund(hospitalized)patient who is
not expected to survive without the operation
p6:a declared brain-dead patient whose organs are being removed for donor purposes
ANESTHESIA TERMINOLOGY AA: anesthesia given by anesthelogist. CRNA: certified registered nurse
anesthelogist SRNA:student registered nurse
anesthetist MAC:monitored anesthesia care AD:medical super vision by a physician
more than 4 concurrent anesthesia procedures
QK:medical direction of 2,3,or 4 concurrent anesthesia procedures.
QY:medical direction of 1 crna by anesthesiologist.
QX:crna service with medical direction by anesthesiologist
QZ:crna services without medical direction by anesthesiologist
QS:MAC services
G8: monitored anesthesia by deep complex, complicated(or)marketly invasive surgical procedure
G9:MAC for a patient who has the history of severe cardiopulmonary condition
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