Changelog

What you will see

Some anesthesia records are printed forms with checkboxes, bubbles, and pre-printed option grids, for example the Graphium anesthesia record and the Graphium "Outside of OR / Patient Visit" form. Text extraction from these forms keeps every printed label but loses which boxes were marked. Before this change, the autocoder could read an empty option as a service. Examples from real records: an unticked "Labor Epid to C-Section" box became a cesarean anesthesia charge with the labor epidural, an empty "A-Line" row became an arterial line, and an empty emergency box became qualifying circumstance 99140.

Now, at facilities that submit these forms, the autocoder receives the page image together with the extracted text on every coding request. It can see which options were marked. On the same labor epidural record it now bills the labor epidural only.

What to look out for

• This is on for facilities that submit paper or checkbox anesthesia forms. If your facility uses these forms and you still see charges that match empty form options, tell your Hank representative.
• Handwritten pages were already read as images. That does not change.
• Long records are limited to ten page images per coding request. The extracted text is always included, so nothing is lost when the limit applies.

Both capabilities below are off unless your organization asks for them. Nothing changes on your claims until then.

A documentation check before a post-operative pain block is billed separately. Your organization declares, per payer type, which evidence must be in the record. The choices are a surgeon order or request, acceptance of transfer of care, a completed consult, a signed block consent, and a separate procedure note. One scan of the whole record checks for that evidence after the claim is built. When evidence is missing, your organization decides the outcome. The block either stays billable and the claim carries a compliance alert, or the block moves to the non-billable list with an informational alert that explains why. The alert names the payer, the evidence found, and the evidence still missing. A record that contains handwritten documents is never moved to non-billable automatically, because a text scan cannot verify marks on paper.

Coding guidance written for your organization. The autocoder can apply your own coding guidance on top of the standard guidance, on your cases only. It covers your guidance for individual codes in anesthesia code selection, your guidance for individual codes in the diagnosis review, and your own instructions for the coding steps. Coverage today is anesthesia.

What to look out for: ask your Hank representative if you want either capability turned on for your organization.

A claim that finishes with no primary anesthesia line is held. The hold fires when an anesthesia claim has no anesthesia line that carries a code. It catches a line that was produced and then removed later, and it catches a case where no code was ever found. A labor epidural (01967) counts as a valid anesthesia line and does not cause the hold.

A claim whose first ranked diagnosis cannot be traced is held. The autocoder must trace the first ranked diagnosis to a stated reason for the procedure. It looks at the anesthesia record after the case, then the record during the case, then the pre-anesthesia evaluation, then the surgeon operative report. The alert names the document that it used.

Modifiers are placed in the order that you configure. Your organization sets the order for surgical modifiers and for anesthesia modifiers. A modifier that is not in your list goes after the listed ones, in alphabetical order.

Two more holds started to fire on 2026-07-01. Those two rules never fired before. One holds a claim with no primary anesthesia code. The other holds a claim with a date of service more than one year old.

What to look out for: organizations that bill procedures only (ICU lines, emergency department blocks, blood patches, canceled cases) will see more held claims. So will organizations that take the first ranked diagnosis from a problem list. Every hold above can be turned off or softened for your organization.