Anesthesia basics

Additional Anesthesia Modifiers 22, 23, 53

by Niels
The following modifiers should be used as secondary or tertiary modifiers only and not as the primary modifier. These modifiers are intended to provide additional information specific to the services provided; there will be no additional reimbursement made for these modifiers. Modifier Description 22 Increased Procedural Service — Per CPT Appendix A modifiers: When the ... Read More

Anesthesia Services overview – For beginner – Type of Anesthesia

by Niels
Services are provided by a qualified anesthesia provider to a surgical patient while in a state of analgesia or anesthesia so that surgical intervention can be undertaken. Anesthesia services consist of the administration of an anesthetic agent, typically by injection or inhalation, causing partial or complete loss of sensation, with or without loss of consciousness. ... Read More

What is Qualifying Circumstances ?

by Niels
Qualifying circumstances are those factors such as extreme age, extraordinary condition of the patient, and unusual risk factors which may affect the anesthesia services. These procedures are considered add-on codes and would not be reported alone, but as additional procedures qualifying an anesthesia procedure or service. These procedures must be filed with the appropriate modifier. ... Read More

modifier AA. AD, QK, QK , QZ How much payment would be reimbursed

by Niels
Modifier Description % of Allowed Charge AA Anesthesia services performed personally by the anesthesiologist 100 percentAD Medical supervision by a physician; more than four concurrent anesthesia procedures. (Three base units + actual time units allowed) 65 percentQK Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals). 65 percentQY Medical direction of ... Read More

Document required for Anesthesia services

by Niels
Medical Direction Medical direction occurs when an anesthesiologist is involved in two, three or four concurrent anesthesia procedures or a single anesthesia procedure with a qualified anesthetist. Payment will be determined for  the physician’s medical direction service of the allowable charge for the physician personally performing the anesthesia services. For each anesthesia procedure, the anesthesiologist ... Read More

Covered and non covered service – would Aneshesia consultation covered seperately ?

by Niels
According to CPT guidelines, the reporting of anesthesia services is appropriate by or under the responsible supervision of a physician. These services may include, but are not limited to, general, regional and supplementation of local anesthesia or other supportive services in order to provide the patient with optimal anesthesia care during any procedure. Covered Services ... Read More

Global payment in Anesthesia services

by Niels
Global Services Global reimbursement of anesthesia administration includes the following: • Pre-anesthesia evaluation [Physicians’ Current Procedural Terminology (CPT) codes 99201-99205, 99221-99223]; • Post-postoperative visits (CPT codes 99211-99215, 99231-99233); • Anesthetic or analgesic administration; • Local anesthesia during surgery; • Monitoring of electrocardiograms (EKGs), pulse breathing, blood pressure, electroencephalogram and other neurological monitoring; • Monitoring of ... Read More

Physical Status Modifiers in Aneshesia services

by Niels
Here is the list of Modifiers in Anesthesia services. P1 A normal health patient ** Informational only; does not impact payment P2 A patient with mild systemic disease ** Informational only; does not impact payment P3  A patient with severe systemic disease ** Informational only; does not impact payment P4 A patient with severe systemic disease that ... Read More

Modifier for Medicaly Directed / Suervised Anesthesia services

by Niels
Medically Directed / Supervised MODIFIER MODIFIER NARRATIVE PROVIDER TYPE ADDITIONAL MEDICARE INFORMATION AD  Medical Supervision by a physician, more than four (4) concurrent anesthesia procedures Anesthesiologist Allow three (3) base units, and one (1) additional base unit when it is demonstrated that the physician was present at the induction QK Medical direction of two, three, ... Read More

Some basic question on Anesthesia billing ?

by Niels
Payment The allowed amount is determined based on the anesthesia procedure that has the highest base unit value. Base Units Do not submit base units on the claim, they will be included in the calculation of the allowed amount. Anesthesia Time ** Submit the exact number of minutes from the preparation of the patient for ... Read More