Below the time based units for anesthesia services.
- 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.
Examples For Anesthesia Time Based Unites
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).
How To Complete 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: 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.
When using an occurrence-based code, enter a “1” for each occurrence. The following codes are paid per occurrence: CPT 01953, CPT 01967, CPT 01968, CPT CPT 01969, CPT 01996, CPT 99100, CPT 99116, CPT 99135 and CPT 99140.