Anesthesia billing basic

Anesthesia Blood Gas Monitoring and Pre-Anesthetic Exams/Cancelled Surgery

by Niels
Blood Gas Monitoring Blood gas monitoring performed as part of an anesthesiologist’s service is considered to be an integral part of the anesthesia service and is not reimbursed separately. Bundled Services 99100© Special anesthesia service 99116© Anesthesia with hypothermia 99135© Special anesthesia procedure 99140© Emergency anesthesia Separate payment will not be allowed for these services; ... Read More

Anesthesia new cpt codes – 99143,99144, 99148,99150

by Niels
2009 CPT Code Descriptions  99143©: Moderate sedation services (other than those services described by codes 00100–01999) provided by the same physician performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; younger ... Read More

Anesthesia payment when multiple anesthesia services and using with modifier

by Niels
MULTIPLE ANESTHESIA SERVICES Same Operative Session Payment can be made for anesthesia services associated with multiple surgical procedures. The payment is based on the anesthesia procedure with the highest base unit value. The time units will equal the actual anesthesia time for both procedures. Example:Provider Date of Service Procedure Time Base Units ABC 01/01/2009 00700 ... Read More

Anesthesia billing when teaching physician involved with example

by Niels
Teaching Physician Medicare pays an unreduced fee schedule payment if a teaching anesthesiologist is involved in a single procedure with one resident. The teaching physician must document in the medical records that he was present during all critical or key portions of the procedure. The teaching physician’s physical presence during only the preoperative or postoperative ... Read More

Concurrent Medically Directed Anesthesia Procedures payment

by Niels
Payment Conditions for Anesthesiology Services Definition of Concurrent Medically Directed Anesthesia Procedures Concurrency is defined with regard to the maximum number of procedures the anesthesiologist 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 ... Read More

Anesthesia payment when wo Anesthesiologists or Two CRNAs

by Niels
Unusual Circumstances – CRNA and Anesthesiologist In unusual circumstances, when it is medically necessary for both the CRNA and the anesthesiologist to be completely and fully involved during a procedure, full payment for the services of each provider is allowed. Each provider must submit documentation to support payment of the full fee. The physician would ... Read More

anesthesial billing payment for Medical Supervision, Group practice, billing documentation

by Niels
Anesthesia Payment  Medical Supervision If an anesthesiologist is medically directing more than four CRNAs, the Medicare regulations indicate that the service must be billed as medically supervised as opposed to medically directed anesthesia services. The anesthesiologist should bill with the AD modifier and the CRNA should bill with the QX modifier. The Medicare payment to ... Read More

Anesthesia billing services

by Niels
ANESTHESIA SERVICES Anesthesia is the administration of a drug or gas to induce partial or complete loss of consciousness. Services involving administration of anesthesia should be reported by the use of the Current Procedural Terminology (CPT) anesthesia five-digit procedure code plus modifier codes. Surgery codes are not appropriate unless the anesthesiologist or Certified Registered Nurse ... Read More

Epidural Opioid Administration

by Niels
Epidural Opioid Administration The intermittent or continuous administration of epidural opioids to treat severe chronic intractable pain of malignant or non-malignant origin is a Medi-Cal benefit, subject to prior authorization.  An implantable infusion pump may be reimbursed when used to administer opioid drugs intrathecally or epidurally in patients with severe chronic intractable pain when the ... Read More

Monitored Anesthesia Care billing problem

by Niels
Monitored Anesthesia Care I am having trouble getting claims for MAC paid. What could be the problem? First of all, each state has a LMRP for MAC (Monitored Anesthesia Care). Within these policies there are anesthesia codes for which no other documentation is necessary to support the necessity of MAC (column A codes). Column B ... Read More