PQRS Healthcare Training: Get the Skinny on Active Warming


The ASA gives us this definition: active warming is over-the-body warming. Now, there's a lot of methods that have been used over the years for over-the-body warming. Read this expert information provided by our expert in a medical billing conference.

You'll see they used to have radiant heat and it was electric; it had a heat element or a carbon polymer. They had water mattresses. And they trouble with those water mattresses because sometimes they leaked. Now, can you imagine that? Having that leak when they're in surgery?

And so they weren't, you know, very practical. They were heavy. They were hard to handle. They were high maintenance. So there are advantages and disadvantages to everything.

But the forced air warming which they introduced in the 1980's, that technology is really now the gold standard and they use that, like, internationally. They have a new recently, there was an innovation as always, new technology comes around and it's a flexible conductive carbon polymer. But whether or not that may be the one that will take the place of the forced-air warming.

You will see on your anesthesia record Bair Hugger. And when you see that Bair Hugger on the anesthesia record checked, you will know what we're talking about. It's the forced-air warming. And that's the device that you will frequently see in a lot of anesthesia records. Have it listed under Bair Hugger if you've ever wondered what that is.

Included means that the patient meets the denominator general or neuraxial. And here are the medical codes, your category II codes 4255-4250 and then active warming not used for an unspecified reason with that 8P.

The ASA really indicates that this is an exclusion that you should rarely if ever report because there is usually some reasons. Excluded are your patients that are on cardiopulmonary bypass or a patient that has a regional anesthesia or that MAC anesthesia. Your cataract surgeries would be excluded.

For cardiac surgery, they usually use some kind of a systemic invasive warming method, maybe a cavity irrigation. And even though it's an exclusion, it still could be excluded for medical reasons. It would not be an 8P. So if you decided to report those exclusions, then you would put the reason, the 1P on it. If everybody starts using that 8P, that's not going to really tell anybody anything.

So you can report the exclusions on the body warming, as suggested by our expert in a health system conference. There again, there is your anesthesia time less than 60 minutes is your 4256. And that is only one code. And that's your fourth method of reporting.

Most of the medical codes do require that you have two codes. So medical reasons, the peripheral nerve block or the intentional hypothermia, sometimes they do it in intentional hypothermia and you would use the 1P.

Here's your descriptions. That 4250 would be recorded. Remember, within 30 minutes, immediately before or 15 minutes immediately after that anesthesia time. And that is the anesthesia time that's on the record.

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