Chart Talk: Anesthesia Coding Conversations

Anesthesia Coding

recent posts

about

Hi! My name is Dianne C. Moseley. I’m a healthcare professional with over 32 years of experience in revenue cycle management. Throughout my career, I’ve worked in every area of RCM, gaining a true understanding of how each part connects to the bigger picture. I am currently certified through AAPC with my CPC, CPCO, CPMA, and CANPC. For the past 15 years, I’ve focused my expertise on anesthesia — a specialty I’m deeply passionate about. I currently work with a large anesthesia group, as a Senior Auditor serving as a Subject Matter Expert, where I focus on optimizing coding accuracy, compliance, education, and revenue integrity. My passion lies in education, process improvement and helping others to succeed. This blog is a space where I will share practical insights, tips, and real-world guidance on anesthesia coding. My goal is to make complex concepts clear, support continuous learning, and help others feel confident navigating the anesthesia coding landscape.

  • Looking Back at 2025 — and Walking Confidently Into 2026

    2025 was a year of deep reflection for me.

    It was the year I finally slowed down enough to ask myself some very hard questions:

    • Am I truly happy in my job?
    • Am I fulfilled by the company and management I work with?
    • Am I satisfied with my certifications and where my career is headed?
    • Where do I see myself in one year? Five years?

    Some of the answers I uncovered weren’t what I expected. And honestly, it took nearly the entire year before I fully realized what was missing.

    What I learned is this: I hadn’t been thinking about me.

    Once that realization set in, things began to shift. I started making intentional changes. I clearly defined what I wanted to accomplish for myself—not what was expected of me, not what felt “safe,” but what actually brought me purpose and joy.

    Despite all of its ups and downs, 2025 ended on a really good note.
    I launched my blog and began welcoming subscribers. I earned an additional certification. I enrolled in the AAPC Instructor Course. Most importantly, I gained clarity—clarity about my goals, my direction, and my why.

    With a renewed vision, I’m stepping into 2026 with new expectations and new opportunities. I know that pursuing dreams doesn’t happen overnight. There will be setbacks, and that’s okay. It’s not a race. Growth happens one step at a time, as long as we keep moving forward and continue doing the things that bring us fulfillment.

    That brings me to something I want to share with you.

    Many people don’t realize that AAPC offers a Mentor/Mentee Program. I’m proud to say that I am signed up as an AAPC Mentor, and I would love to connect with and support others in achieving their goals—whether that’s certification guidance, career direction, or simply encouragement from someone who’s been there.

    If you’re interested, I encourage you to check it out here:
    👉 https://www.aapc.com/resources/mentorship-program

    Let’s make 2026 the best year yet—for our careers, our growth, and for chasing the dreams we’ve been putting off for far too long.

    Here’s to learning, evolving, and believing in ourselves.

  • 2026 CPT® Code Changes: What to Expect and How to Prepare

    As we move closer to 2026, it’s time to start looking ahead at the upcoming CPT® code changes and what they mean for providers, coders, and revenue cycle teams. Each annual update reflects how healthcare continues to evolve—and the 2026 CPT code set is no exception.

    Whether you’re involved in coding, billing, compliance, or clinical documentation, understanding the overall direction of these changes can help you prepare early and avoid last-minute surprises.

    A High-Level Look at the 2026 CPT® Updates

    The 2026 CPT® code set includes a combination of new, revised, and deleted codes across multiple specialties. As with prior years, the intent is to improve accuracy, reflect current clinical practice, and better align reporting with how care is actually delivered.

    Rather than focusing on volume alone, the 2026 updates emphasize:

    • Greater specificity
    • Clearer code descriptors
    • Improved alignment with technology-driven care
    • Reduced ambiguity that can lead to denials or inconsistent reporting

    Key Themes Driving the 2026 CPT® Changes

    1. Expansion of Digital and Remote Services

    Digital health continues to grow, and CPT® codes are evolving to keep pace. Updates for 2026 further refine reporting for remote patient monitoring (RPM) and related management services, including clearer guidance around monitoring duration and time-based thresholds.

    These changes aim to:

    • Better define short-term vs. ongoing monitoring
    • Clarify time requirements for treatment management
    • Improve consistency in reporting remote services

    2. Increased Use of Technology and Augmented Intelligence

    The 2026 CPT® updates acknowledge the expanding role of advanced technology and algorithm-assisted analysis in clinical care. New and revised codes capture services where clinicians use advanced tools to support interpretation, decision-making, and diagnostic insight.

    This is an important step toward recognizing how technology enhances—but does not replace—clinical judgment.

    3. Updates in Procedural and Interventional Coding

    Several procedural areas see refinement in 2026, particularly where prior coding structures lacked clarity or failed to reflect procedural complexity.

    Expect updates that:

    • Improve differentiation between procedural approaches
    • Clarify bundled versus separately reportable services
    • Align code descriptors more closely with current techniques

    These refinements are especially important for accurate documentation and audit defense.

    4. Continued Emphasis on Documentation Clarity

    Across the code set, there is a noticeable focus on clearer definitions and parenthetical guidance. This includes refined descriptors, updated instructional notes, and clearer expectations for reporting.

    For coders and auditors, this means:

    • Less reliance on interpretation
    • More consistency across teams
    • Stronger support for compliant billing

    What This Means for Coders and Practices

    With an effective date of January 1, 2026, preparation is key. Now is the time to:

    • Review new, revised, and deleted codes relevant to your specialty
    • Update internal references, cheat sheets, and education materials
    • Begin conversations with clinicians about documentation expectations
    • Ensure systems and workflows are ready to support the changes

    Early education and proactive planning can significantly reduce claim delays, denials, and rework once the new code set goes live.

    Looking Ahead

    The 2026 CPT® code changes reflect a broader shift in healthcare—one that values precision, technology integration, and documentation that tells the full story of patient care.

    In upcoming posts, we’ll take a deeper dive into specialty-specific updates, highlight high-impact changes, and share practical tips for applying the new codes confidently.

    If there’s a specific area you’d like covered in addition to anesthesia – such as cardiovascular services, or another specialty—I’d love to hear your suggestion. Remember in order to ensure that we have the correct crosswalk, it al begins with the CPT code.

  • A Little Quiet… and a Lot of Planning Ahead ✨

    If you’ve noticed things have been a bit quiet here lately, I wanted to take a moment to share why—and what’s coming next.

    Between the holidays, a very full work schedule, and the day-to-day demands that come with both, posting took a short pause. That said, the quiet hasn’t meant inactivity. Behind the scenes, there’s been a lot of reflection, planning, and learning.

    I’m still new to blogging and very much in the “figuring it out” phase—learning what works, what doesn’t, and how to create content that’s not only informative but truly useful to you. Part of that process is understanding how you prefer to engage:

    • What topics help you most?
    • What formats do you enjoy—quick tips, deep dives, visuals, real-world examples?
    • How can this space better support your learning and growth?

    Looking ahead, 2026 is shaping up to be an exciting and education-focused year. My goal is to bring more intentional, practical, and approachable content—especially around topics that help simplify complex concepts and support continued learning.

    I’m always open to suggestions and feedback. If there’s something you’d like to see covered, explained differently, or expanded on, please don’t hesitate to share. This blog is meant to grow with you, not just in front of you.

    Thank you for your patience, your support, and for being part of this journey. I’m looking forward to what’s ahead—and I’m glad you’re here.

  • In the Zone – December 2025

    December 2025 NewsletterDownload

  • Are You Studying for Your CANPC Certification?

    I wanted to check in with the community—is anyone currently preparing for the CANPC (Certified Anesthesia and Pain Management Coder) exam? If so, I’d love to hear from you!

    Studying for CANPC can feel overwhelming at times. Between mastering anesthesia time, navigating ASA crosswalks, understanding pain management interventions, and keeping up with evolving guidelines, there’s a lot to juggle. But we don’t have to do it alone.

    What are you finding most challenging?
    – Anesthesia coding concepts?
    – Interventional pain procedures?
    – Nerve blocks and imaging guidance?
    – Modifiers?
    – Time calculations?
    – Exam strategy?

    Drop a comment below and share what you’re struggling with — or even a tip that has helped you. Together, we can create a supportive space for everyone on their CANPC journey.

    Let’s learn from each other and encourage one another to keep going.

  • How Anesthesia Charges Are Calculated

    1. Base Units

    • Assigned by ASA to each anesthesia CPT code.

    • Represent procedure complexity.

    • Fixed amount—does not change with case duration.

    2. Time Units

    • Begins when anesthesia care starts; ends when no longer personally providing services.

    • Most payers: 1 unit = 15 minutes.

    • Medicare: billed based on actual minutes.

    How to calculate and report anesthesia time properly depends on the payer. For payers that follow CPT® rules, report time per 15 minute intervals. At least half this time (7.5 minutes) must pass to report a unit. For example:

    30 minutes of anesthesia = two units (30=15+15)

    38 minutes of anesthesia = three units (38=15+15+8)

    37 minutes of anesthesia = two units (37=15+15+7)

    Medicare providers follow Centers for Medicare & Medicaid Services guidelines, found in the Internet Only Manual, Claims Processing

    Manual 100-04 Chapter 12:

    G. Anesthesia Time … is defined as the period during which an anesthesia practitioner is present with the patient. It starts when the anesthesia practitioner begins to prepare the patient for anesthesia services in the operating room or an equivalent area and ends when the anesthesia practitioner is no longer furnishing anesthesia services to the patient, that is, when the patient may be placed safely under postoperative care. Anesthesia time is a continuous time period from the start of anesthesia to the end of an anesthesia service. In counting anesthesia time for services furnished on or after January 1, 2000, the anesthesia practitioner can add blocks of time around an interruption in anesthesia time as long as the anesthesia practitioner is furnishing continuous anesthesia care within the time periods around the interruption. Actual anesthesia time in minutes is reported on the claim. For anesthesia services furnished on or after January 1, 1994, the A/B MAC computes time units by dividing reported anesthesia time by 15 minutes. Round the time unit to one decimal place. The A/B MAC does not recognize time units for CPT codes 01995 or 01996. For purposes of this section, anesthesia practitioner means a physician who performs the anesthesia service alone, a CRNA who is not medically directed, or a CRNA or AA, who is medically directed. The physician who medically directs the CRNA or AA would ordinarily report the same time as the CRNA or AA reports for the CRNA service.

    3. Modifying Units

    • Added based on patient risk or circumstances.

    • Physical Status: P3 (+1), P4 (+2), P5 (+3) for commercial payers.

    • Emergency modifier (ET) may increase payment.

    • Medical direction modifiers (AA, QK, QX, QZ) affect payment split.

    4. Anesthesia Billing Formula

    • (Base Units + Time Units + Modifying Units) × Conversion Factor (CF) = Charge

    5. Example

    Procedure: Lap Chole (ASA 00790)

    Base Units: 7

    Time: 90 minutes → 6 units (90 ÷ 15)

    Modifier: P3 (+1 unit)

    CF: $25

    Total Units: 7 + 6 + 1 = 14

    Charge: 14 × $25 = $350

    6. Documentation Essentials

    • Accurate anesthesia start & stop times required.

    • Only one ASA code billed per encounter.

    • Include provider type (MD/CRNA) and applicable modifiers.

    Quick Summary

    Charges depend on:

    • Base Units

    • Time Units

    • Modifying Units

    • Conversion Factor

    Formula: Total Units × CF = Reimbursement

    Anesthesia CPT CodesDownload

  • 🍁 Happy Thanksgiving to My Incredible Subscribers! 🦃

    As we celebrate this season of gratitude, I want to take a moment to say thank you from the bottom of my heart. Your support, your encouragement, and your willingness to follow along on my blog and personal journey mean more to me than you know.

    This year, I’m especially grateful for you — every reader, every comment, every shared moment. You’ve been part of my growth, my learning, and my continued push toward the dream that fuels me: becoming an educator who can make a difference.

    I’m thankful that I’m still able to chase that dream. I’m thankful for the opportunities still in front of me. And I’m thankful that you’ve chosen to walk alongside me as this vision becomes clearer and closer.

    May your Thanksgiving be filled with warmth, peace, good food, and the people who bring light into your life.

    Thank you for being here.

    Thank you for believing in this journey.

    And thank you for believing in me.

    Wishing you a beautiful Thanksgiving! 🍂💛

  • Pecked by a Turkey

  • What Constitutes “Instrumentation” in Spinal Cases ~ ASA 00670

    In spinal surgery, instrumentation refers to any hardware implanted into the spine to provide stability, correction, or fixation. It is used to immobilize spinal segments, maintain alignment, or support fusion.

    Common Types of Spinal Instrumentation

    1. Pedicle Screws
    • Placed through the pedicle into the vertebral body
    • Provide the primary anchor point
    • Used in almost all thoracolumbar fusions
    2. Rods
    • Long metal rods connecting pedicle screws
    • Allow correction of deformity and stabilization
    3. Plates
    • Anterior cervical plates most common
    • Secured with screws to maintain alignment after fusion
    4. Interbody Devices (Cages)
    • Inserted into the disc space
    • Restore disc height
    • Promote fusion with bone graft
    5. Hooks
    • Used in scoliosis or deformity surgery
    • Anchor at lamina or transverse process
    6. Wires / Cables
    • Sublaminar wires or titanium cables
    • Used when screw purchase is poor
    7. Crosslinks
    • Connect left and right rod to increase torsional stability

    Coding Note (If You Need It for CPT Documentation)

    Instrumentation is coded separately from the fusion procedure, usually using:

    • 22840–22847 for posterior segmental/nonsegmental instrumentation
    • 22853–22859 for interbody devices
    • 22848 for crosslink placement
    • +22899 for unlisted situations

  • 2026 ICD-10-CM Code Updates ~ New Codes – Chapter 8 – 10

    Chapter 8 (H60 – H95)

    Diseases of the Ear and Mastoid Process

    • “No New Codes”

    Chapter 9 (I00 – I99)

    Diseases of the Circulatory System 

    • “4 New Codes”

    I27.84 – Fontan related circulation

    • I27.840 – Fontan-associated liver disease [FALD]
    • I27.841 – Fontan-associated lymphatic dysfunction
    • I27.848 – Other Fontan-associated condition
    • I27.849 – Fontan related circulation, unspecified

    Chapter 10 (J00 – J99)

    Diseases of the Respiratory System

    •  “No New Codes”