Month: June 2016

billing anesthesia time units – calculation for personally performed and Medical direction

by Niels
Anesthesia Payment & Billing Information Time and Points Eligible Anesthesia Procedures Defined Blue Cross and Blue Shield of Texas has determined that certain anesthesia procedures will be reimbursed on time and points methodology. Procedures  that  are   not  included  on  the   Anesthesia  Time  &  Points Eligible List will not be reimbursed using time and ... Read More

Anesthesia Time and Calculation of Anesthesia Time Units

by Niels
Anesthesia time is defined as the period during which an anesthesia practitioner is present with the patient. It starts when the anesthesia practitioner begins to prepare the  patient for anesthesia services in the operating room or an equivalent area and ends when the anesthesia practitioner is no longer furnishing anesthesia services to the patient, that ... Read More

Billing and Payment for Multiple Anesthesia Procedures

by Niels
Physicians bill for the anesthesia services associated with multiple bilateral surgeries by reporting the anesthesia procedure with the highest base unit value with the multiple procedure modifier “-51.” They report the total time for all procedures in the line item with the highest base unit value. If the same anesthesia CPT code applies to two ... Read More

Payment at the Medically Directed Rate

by Niels
The Part B Contractor determines payment for the physician’s medical direction service furnished on or after January 1, 1998, on the basis of 50 percent of the allowance for the service performed by the physician alone. Medical direction occurs if the physician medically directs qualified individuals in two, three, or four concurrent cases and the ... Read More

BCBS claim filing limit for Anesthesia claims

by Niels
Claim Filing Effective for dates of service on or after January 1, 2014, Blue Cross requires claims for anesthesiologists, CRNAs and AAs to be billed under the name and National Provider Identifier (NPI) of the provider who  actually rendered the service. Blue Cross does not recognize “incident to” billing for anesthesia services. All providers should ... Read More

Payment at Personally Performed Rate

by Niels
The Part B Contractor must determine the fee schedule payment, recognizing the base unit for the anesthesia code and one time unit per 15 minutes of anesthesia time if: • The physician personally performed the entire anesthesia service alone; • The physician is involved with one anesthesia case with a resident, the physician is a ... Read More

Regional Anesthesia CPT code 01967, 01968 and 01969

by Niels
Topical anesthesia, local, local infiltration and/or metacarpal/digital block, is included in the basic allowance of the surgical procedure performed. No additional reimbursement is provided. • Nerve Blocks -A nerve block involves the injection of a peripheral nerve into or around a given site. If the anesthesiologist administers the injection or block postoperatively in an area ... Read More

Anesthesia During Delivery CPT codes 01967, 99140,

by Niels
Labor Epidurals Anesthesia for labor epidurals are time-based services and should be billed as total minutes. CPT code 01967: Neuraxial Labor Analgesia/Anesthesia for Planned Vaginal Delivery This includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor.)  Code may be reported as a single anesthesia service. ... Read More

Medical Direction and Medical supervision difference

by Niels
Billing for Medical Direction When an anesthesiologist medically directs the services of a CRNA or AA, it is recommended that two separate claims should be submitted using the same CPT code and the same amount of time on each claim with the appropriate modifiers. In unusual circumstances, such as complicated trauma case, it may be ... Read More

How to submit a claim for Co surgeons and Team surgeons – Full guide with example

by Niels
A. General Under some circumstances, the individual skills of two or more surgeons are required to perform surgery on the same patient during the same operative session. This may be required because of the complex nature of the procedure(s) and/or the patient’s condition. In these cases, the additional physicians are not acting as assistants-at-surgery. B. ... Read More