Month: July 2016

Anesthesia incorrect modifier usage

by Niels
Anesthesia Modifiers *not an all-inclusive list.  Modifiers must be billed with anesthesia procedure codes to indicate whether the procedure was personally performed, medically directed or medically supervised. Service will deny:  · When billed without appropriate modifier for provider’s specialty · When modifier is not billed in the appropriate modifier position. · When billed with invalid ... Read More

Anesthesia billing Which form to use

by Niels
A. GENERAL BILLING INFORMATION  Electronic (EDI) HIPPA 5010 compliant 837P format claim submission – Submit total time in minutes in the appropriate field Paper claim submission  – Submit claim using the most current CMS-1500 form.  – Submit total minutes in the unit field. – Submit actual start and stop time (ex. 12:00 to 13:00 or ... Read More

CPT code 01952, 01996

by Niels
Anesthesia for Burns CPT code 01952 is the primary code for billing Anesthesia for Second and Third Degree Burn Excision or Debridement With or Without Skin Grafting. The add-on CPT code 01953 is not considered an anesthesia management service and should not be reported with time. CPT code 01953 may be reported with units of ... Read More

Anesthesia and Medical/Surgical Service Provided by the Same Physician

by Niels
Anesthesia services range in complexity. The continuum of anesthesia services, from least intense to most intense in complexity is as follows: local or topical anesthesia, moderate (conscious) sedation, regional anesthesia and general anesthesia. Prior to 2006, Medicare did not recognize separate payment if the same physician provided the medical or surgical procedure and the anesthesia ... Read More

When to use Modifier 59, 73, 74 IN Anesthesia billng?

by Niels
59 Distinct Procedural Service — Services with modifier 59 may be subject to review of medical records. Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day. Modifier 59 is used to identify procedures/services, other than E/M services, ... Read More

Definition of Concurrent Medically Directed Anesthesia Procedures with time calculation example

by Niels
Concurrency is defined with regard to the maximum number of procedures that the physician is medically directing within the context of a single procedure and whether these other procedures overlap each other. Concurrency is not dependent on each of the cases involving a Medicare patient. For example, if an anesthesiologist directs three concurrent procedures, two ... Read More