Month: October 2016

Billing Exclusions For Anesthesia

by Niels
A surgeon or physician may not bill for anesthesia performed at the same time he/she is performing the surgery. This includes conscious sedation codes 99143, 99144, 99145, 99148, 99149 and 99150. Conscious sedation and local anesthetic when performed with a procedure are considered to be a part of the global surgical package and not separately ... Read More

CPT code 69436, 69421, 69433, 69420 Tympanostomy general aneshtesia

by Niels
procedure code and description 69436 –  Tympanostomy (requiring insertion of ventilating tube), general anesthesia  – average fee payment – $170 – $180 69420 Myringotomy including aspiration and/or eustachian tube inflation 69421 Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia 69424 Ventilating tube removal requiring general anesthesia 69433 Tympanostomy (requiring insertion of ventilating tube), local ... Read More

Anesthesia for CAT Scans and MRI Procedures

by Niels
Payment can be made for anesthesia for computerized axial tomography (CAT) or magnetic resonance imaging (MRI) scans by Blue Cross if there is documentation supporting the medical necessity of the anesthesia such as: • Convulsive disorders; • Tremors of the head and body; • Cerebral palsy, Parkinson’s Disease; • Children too young to cooperate, and/or ... Read More

BILLING Guide for CRNA Anesthesia services with example

by Niels
Certified Registered Nurse Anesthetists (CRNA) Services  Neighborhood will require all CRNA(s) to become individually credentialed Effective 10/1/2014 Neighborhood will begin reimbursing CRNA services at a percentage of anesthesia allowable. CRNA must be credentialed on the date of service in order to receive reimbursement for the service and all claims must be billed using the CRNA’s ... Read More

Anesthesiologist and CRNA required modifiers

by Niels
Required Modifiers Required Modifiers for  Anesthesiologist    Description     Reimbursement AA Anesthesia services personally performed by anesthesiologist 100 percent of allowable amount AD Medical supervision by a physician, more than four concurrent anesthesia procedures Max 3 base units + time units) effective 10/1/2014 date of service QK Medical direction of two, three or four ... Read More

General Billing Guidelines for Anesthesia

by Niels
Anesthesia billed by an anesthesia practitioner should be billed on the CMS 1500 or 837 P with the appropriate 5-digit CPT code 00100 – 01995 or 01999 in effect for the date the services were rendered with the appropriate payment modifier. There are four anesthesia categories as determined by CMS that affect payment of anesthesia ... Read More