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CPC - Anesthesia and Evaluation and Management - Section 3.1

Assign anesthesia codes and compute anesthesia time and physical status, applying base units, time units, and qualifying circumstances where relevant.

Select the correct anesthesia code for the surgical procedure performed, append the physical status modifier (P1 to P6), and recognise how base units, reported anesthesia time, and qualifying-circumstance add-on codes combine in the anesthesia formula. Distinguish anesthesia services from moderate (conscious) sedation, and apply the rule that anesthesia for multiple procedures is reported with the single highest base-unit code.

Anesthesia sectionBase units and time unitsPhysical status modifiersQualifying circumstances

Practice question for this objective

Free sampleAnesthesia and Evaluation and Managementhard

An anaesthetist reports a case in which the anaesthesia code carries a base value of 5 units. Anaesthesia time totals 90 minutes, counted as one time unit per 15 minutes, and the patient is assigned physical status P3, which this payer recognises as one modifying unit. Qualifying circumstances do not apply. What is the total number of anaesthesia units reported?

Base value = 5 units
Anaesthesia time = 90 minutes
1 time unit = 15 minutes
P3 = 1 modifying unit
  • A11 units.
  • B13 units.
  • C12 units. Correct
  • D10 units.
Compute total anaesthesia units as base units plus time units plus any recognised modifying units. The anaesthesia formula sums base units, time units, and any recognised modifying units, so with 90 minutes equal to six time units and P3 adding one modifying unit, the total is five plus six plus one, which is twelve.

Why A is wrong: Tempting if only base and time are added, giving five plus six, but the payer here recognises the P3 physical status as one extra modifying unit, which must be included in the total.

Why B is wrong: Tempting if P3 is counted as two modifying units, but P3 adds only one unit, while the two-unit modifying value belongs to P4 rather than P3.

Why C is correct: Base 5 plus 6 time units for the 90 minutes plus 1 modifying unit for physical status P3 gives five plus six plus one, which equals twelve total units.

Why D is wrong: Tempting if the 90 minutes is divided into five units, but 90 divided by 15 is six time units, and base and physical status are then added on top.

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