Anesthesia billing basic

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

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

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

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

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 Modifiers – Primary and Secondary, Tertiary

by Niels
Modifiers are two-digit indicators that are used with a procedure code to add specific meaning to a service provided. Every anesthesia administrative code billed to Florida Blue must include a modifier. More than one modifier can be submitted per detail line; however, the Florida Blue claims system will adjudicate the claim based only on the ... 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