Month: June 2010

Payment for Medically directed and non medically directed rate

by Niels
PAYMENT AND REIMBURSEMENT Payment at Personally Performed Rate The fee schedule payment for a personally performed procedure is based on the full base unit and one time unit per 15 minutes of service if the physician personally performed the entire procedure. Modifier AA is appropriate when services are personally performed. Payment at Medically Directed Rate ... Read More

Monitored Anesthesia Care and Pain Management Consultation

by Niels
Monitored Anesthesia Care Monitored anesthesia care involves intraoperative monitoring by a physician or qualified individual under the medical direction of a physician or of the patient’s vital physiological signs in the anticipation of the need for administration of general anesthesia or of the development of adverse physiological patient reaction to the surgical procedure. It also ... Read More

Insurance Payment rule for Anesthesia Medically supervised rate

by Niels
Payment at Medically Supervised Rate Only three (3) base units per procedure are allowed when the anesthesiologist is involved in rendering more than four (4) procedures concurrently or is performing other services while directing the concurrent procedures. An additional time unit can be recognized if the physician can document he/she was present at induction. Modifier ... Read More

Procedure code D9230, D9220 – DENTAL ANESTHESIA/SEDATION

by Niels
EPSDT DENTAL PROGRAM Dental Hospital Calls and Sedation Policy Revisions D9230 NITROUS OXIDE – analgesia, anxiolysis, inhalation of nitrous oxide Current Policy: Nitrous oxide inhalation analgesia is only payable to providers whopossess a personal permit for its administration from the Louisiana State Board of Dentistry and administer it in a State Board approved facility. Nitrous ... Read More

Anesthesia billing tips

by Niels
Some specific points that you should be aware of: �� CPT coding guidelines for conscious sedation codes instruct practices not to report Codes 99143 to 99145 in conjunction with the codes listed in CPT Appendix G. NHIC will follow the National Correct Coding Initiative, which added edits in April 2006 that bundled CPT codes 99143 ... Read More

Medical direction anesthesia – personally performed

by Niels
Medical Direction & Temporary Relief CRNAs/AAs providing anesthesia services under the medical direction of an anesthesiologist must have uninterrupted immediate availability of an anesthesiologist at all times. When a medically directing anesthesiologist provides temporary relief to another anesthesia provider, the need for uninterrupted immediate availability may be met by any of the following strategies: • ... Read More

Medical and Surgical Services Rendered in Addition to Anesthesia Procedures

by Niels
ANESTHESIA SERVICES Medical and Surgical Services Rendered in Addition to Anesthesia Procedures Payment may be made under the fee schedule for specific medical and surgical services by the anesthesiologist as long as these services are reasonable and medically necessary or provided other rebundling provisions do not preclude separate payment. These services may be rendered in ... Read More

Anesthesia Group practice billing

by Niels
GROUP PRACTICE If anesthesiologists are in a group practice, one physician member may provide the preanesthesia examination and evaluation while another fulfills the other criteria. Similarly, one physician member of the group may provide post-anesthesia care while another member of the group furnishes the other component parts of the anesthesia service. The medical record must ... Read More

Anesthesia – General and common information

by Niels
GENERAL INFORMATION A Physician, a Certified Registered Nurse Anesthetist (CRNA) or Anesthesiologist Assistant under the medical supervision of a physician, may provide anesthesia services. Provider Qualifications Physician – Anesthesiologist Physician is defined as a doctor of medicine who is legally authorized to practice in the State in which he/she performs services. The issuance of a ... Read More

Separately Reimbursable Anesthesia Services

by Niels
Medi-Cal insurance separately reimburses for the following anesthesia services. CPT-4 Code    Definition 36555    Insertion of non-tunneled centrally inserted central venous catheter; under 5 years of age 36556    Age 5 years or older 36568    Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; under 5 years of age 36569        Age 5 ... Read More