New
Two new holds on anesthesia claims, plus modifier order that you configure
Work processed after carries this change.
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Every release and every piece of in-flight work for Medical Auto Coding. Filter by status, kind, or tag, then read the full notes below.
| Status | Kind | What changed | Version | Ticket | Date |
|---|---|---|---|---|---|
| Released | New | Two new holds on anesthesia claims, plus modifier order that you configure | No version | No ticket |
Work processed after carries this change.
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.