How To Use CPT Code 00192

cpt 00192 describes anesthesia services for procedures on the facial bones or skull, specifically radical surgery including prognathism. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 00192.

1. What is cpt 00192?

cpt 00192 is a code used to describe anesthesia services provided during radical surgery procedures on the facial bones or skull, including prognathism. This code is specifically for anesthesia services and does not include the surgical procedure itself. It is used to indicate that the patient received anesthesia during the surgery to ensure their comfort and safety.

2. Official Description

The official description of cpt 00192 is: ‘Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)’. This code represents the anesthesia services provided by the anesthesia provider during radical surgery on the facial bones or skull, including cases involving prognathism.

3. Procedure

The anesthesia provider performs several key responsibilities during cpt 00192:

1. Preoperative evaluation: The anesthesia provider assesses the patient’s medical history, current health status, and any potential risks or complications related to anesthesia.
2. Anesthesia induction: The anesthesia provider administers anesthesia to the patient, ensuring they are in a state of unconsciousness and pain-free during the surgical procedure.
3. Monitoring: The anesthesia provider closely monitors the patient’s vital signs, such as heart rate, blood pressure, oxygen levels, and anesthesia depth, throughout the surgery.
4. Medication administration: The anesthesia provider administers medications, such as anesthesia agents and pain relievers, as needed to maintain the patient’s comfort and stability.
5. Documentation: The anesthesia provider records the types and amounts of medications administered, monitoring methods used, patient responses, and the start and stop times of anesthesia care.
6. Postoperative care: After the surgery, the anesthesia provider oversees the patient’s transfer to the postanesthesia care unit and ensures their safe recovery from anesthesia.

4. Qualifying circumstances

cpt 00192 is used for patients undergoing radical surgery procedures on the facial bones or skull, including prognathism. These procedures involve extensive surgical intervention and may carry higher risks and complexities, requiring the presence of an anesthesia provider to ensure the patient’s safety and comfort. The anesthesia provider must be qualified and authorized to administer anesthesia, such as an anesthesiologist, doctor of medicine or osteopathy, dentist, oral surgeon, podiatrist, certified registered nurse anesthetist (CRNA), or anesthesiologist assistant (AA).

5. When to use cpt code 00192

cpt 00192 should be used when the patient undergoes radical surgery procedures on the facial bones or skull, including prognathism, and requires anesthesia services. It is important to note that cpt 00192 represents the anesthesia services only and should not be used to report the surgical procedure itself. Anesthesia services are essential to ensure the patient’s comfort and safety during the surgery.

6. Documentation requirements

To support a claim for cpt 00192, the anesthesia provider must document the following information:

• Patient’s medical history and physical examination
• Preoperative evaluation and assessment
• Anesthesia induction and medications administered
• Monitoring methods used during the surgery
• Patient’s vital signs and anesthesia depth throughout the procedure
• Start and stop times of anesthesia care
• Any complications or adverse events during anesthesia
• Postoperative care and transfer to the postanesthesia care unit
• Signature of the anesthesia provider

7. Billing guidelines

When billing for cpt 00192, ensure that the anesthesia services were provided during radical surgery procedures on the facial bones or skull, including prognathism. It is important to accurately document the anesthesia time, which starts when the anesthesia provider prepares the patient for anesthesia induction and ends when the provider no longer renders services or another provider assumes responsibility for postoperative care. Anesthesia time is typically reported in units, with each unit representing a specific time increment determined by the payer. Additional guidelines may vary depending on the specific payer’s requirements.

8. Historical information

cpt 00192 was initially added to the Current Procedural Terminology system on January 1, 1990, to describe anesthesia for procedures on facial bones. It underwent a code change on January 1, 2001, to include radical surgery, including prognathism. Medicare made changes to its Inpatient Only (IPO) list, removing cpt 00192 in 2021 but adding it back in 2022.

These codes represent anesthesia services provided during various procedures on the salivary glands, including biopsy, duct procedures, and radical surgery with or without extensive neck dissection.

9. Examples

1. An anesthesiologist providing anesthesia services during a radical surgery procedure on the facial bones for a patient with prognathism.
2. A certified registered nurse anesthetist (CRNA) administering anesthesia to a patient undergoing a complex facial bone reconstruction surgery.
3. An oral surgeon providing anesthesia services during a maxillofacial surgery involving the facial bones.
4. A dentist administering anesthesia to a patient undergoing orthognathic surgery to correct a jaw misalignment.
5. An anesthesiologist assistant (AA) assisting in the administration of anesthesia during a craniofacial surgery for a patient with facial bone abnormalities.
6. A doctor of medicine providing anesthesia services during a radical surgery procedure on the skull for a patient with a cranial deformity.
7. A podiatrist administering anesthesia to a patient undergoing a facial bone procedure as part of a comprehensive foot and ankle reconstruction surgery.