Anesthesia billing basic

Anesthesiologist billing process

by Niels
Anesthesia Services and Teaching AnesthesiologistIf a teaching anesthesiologist is involved in a single procedure with one resident, the anesthesia services will be paid at the personally performed rate. The teaching physician must document in the medical records that he or she was present during all critical (or key) portions of the procedure. The teaching physician’s ... Read More

Billing concurrent Medically directed procedures

by Niels
Concurrent Medically Directed Procedures 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 the other procedures overlap each other. Concurrency is not dependent on each of the cases involving a Medicare patient. For example, if an anesthesiologist directs ... Read More

Medical anesthesia billing policy

by Niels
ASA Physical Status Class 3 For a patient with severe systemic disease, ASA Physical Status Class 3 (for example, severe essential hypertension or severe chronic obstructive pulmonary disease), use modifier -P3. ASA Physical Status Class 4 Non-Emergency For a patient with severe systemic disease that is a constant threat to life, ASA Physical Status Class ... Read More

Anesthesia Start Time – When Does it Start?

by Niels
Anesthesia Start Time – When Does it Start? Anesthesia time starts when the anesthesiologist begins to prepare the patient for anesthesia care in the operating suite or equivalent area. Time ends when the anesthesiologist is no longer in personal attendance and the patient may be safely placed under post-operative supervision Medicare requires the actual time ... Read More

General Anesthesia Reimbursement Limitations – Medical insurance

by Niels
Duplicate Billing Not Allowed Medi-Cal policy prohibits payment for duplicate services and/or billings.  The second and subsequent claims for anesthesia services billed for the same date of service, the same recipient and the same procedure submitted by the same or different providers will be denied with RAD code 328, “Another procedure with an anesthesia modifier ... Read More

Referring provider and POS

by Niels
Referring Provider Information Effective July 1, 2004, anesthesia providers must submit the UPIN number of the referring surgeon/physician on the claim. If you file hard copy, the UPIN number should be populated in block 1 7a of the CMS 1500 claim form. For those who file electronically, you should submit the referring surgeon/physician’s UPIN number. ... Read More

Clients Enrolled in a Managed Care Plan – Anesthesiology

by Niels
Clients Enrolled in a Managed Care Plan – Anesthesiology – Medicaid A Medicaid client enrolled in a managed health care plan, such as a health maintenance organization (HMO), must receive all health care services through that plan.Each plan may offer more benefits and/or fewer restrictions that the Medicaid scope of benefits explained in the section ... Read More

Anesthesia Billing for Obstetrics

by Niels
Anesthesia Billing for Obstetrics  In many cases the Anesthesiologist or the CRNA places the epidural and leaves the patients side once dosage has been tested, checking back only periodically throughout labor progression. Different anesthesia groups document this in varying forms. Due to widespread variances in the fee calculation of these services, tracking payment trends accurately ... Read More

Procedure code D9230, D9220 – DENTAL ANESTHESIA/SEDATION

by Niels
EPSDT DENTAL PROGRAM Dental Hospital Calls and Sedation Policy Revisions D9230 NITROUS OXIDE – analgesia, anxiolysis, inhalation of nitrous oxide Current Policy: Nitrous oxide inhalation analgesia is only payable to providers whopossess a personal permit for its administration from the Louisiana State Board of Dentistry and administer it in a State Board approved facility. Nitrous ... Read More

Monitored Anesthesia Care and Pain Management Consultation

by Niels
Monitored Anesthesia Care Monitored anesthesia care involves intraoperative monitoring by a physician or qualified individual under the medical direction of a physician or of the patient’s vital physiological signs in the anticipation of the need for administration of general anesthesia or of the development of adverse physiological patient reaction to the surgical procedure. It also ... Read More