During the first 4 hours of service, 15 minutes equals 1 unit. If services are provided for longer than 4 hours in one occurrence, each 10-minute
period after the initial 4 hours equals 1 unit. A period less than a unit should be rounded up to the next unit.
Example A: 5 hours or 300 minutes equals 22 units – 16 units for the first 4 hours (1 unit per each 15 minutes) and 6 units for the last hour
(1 unit per each 10 minutes).
Example B: 128 minutes is billed as 9 units (8 units for the first 120 minutes and 1 additional unit for the remaining 8 minutes).
Completing the Claim Form
The following instructions are specific to anesthesia services and must be used in conjunction with the complete CMS-1500 Claim Form Instructions provided on First Health Services’ website (select “Billing Information” from the “Providers” menu).
· Field 19: When billing a time-based code, enter the total minutes of reportable anesthesia time in Field 19.
· Field 24D: On the bottom, white half of the claim line, enter one CPT code and one physical status modifier (P1-P6). List additional modifiers when appropriate.
· Field 24G:
o When using a time-based code, enter the number of reportable
anesthesia time units; do not add base units or modifier units to the
time units.o When using an occurrence-based code, enter a “1” for each occurrence. The following codes are paid per occurrence: 01953, 01967, 01968, 01969, 01996, 99100, 99116, 99135 and 99140.
