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Spring 2008


Medicare Now Values CPT - Code 00797 at the Correct Level - 11 Base Units

When the 2008 Medicare Fee Schedule first appeared, the American Society of Anesthesiologists (ASA) contacted the Center for Medicare and Medicaid Services (CMS) to report an error posted on the CMS website. The error incorrectly listed the base units for CPT Code 00797, Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy gastric restrictive procedure for morbid obesity. The correct base unit value, 11 units, is now listed on the CMS website at http://www.cms.hhs.gov/center/anesth.asp.

ASA was informed by CMS that Medicare carriers received the correct base unit information printed in the HCPCS file in late 2007. Until recently Medicare therefore processed all 2008 claims for 00797 at the 11 base unit value rather than the incorrect posting of 8 base units. ASA noted that some private payers may have used the incorrectly-posted base unit value from the CMS website.

On behalf of our clients, we have reviewed the CPT code 00797 payments paid to our clients and we will contact any third party payers to ensure proper reimbursement. For others, we highly recommend sharing the corrected web posting with your third party payers so you may be reimbursed properly.