Anesthesia billing basic

GENERAL INFORMATION A Physician, a Certified Registered Nurse Anesthetist (CRNA) or Anesthesiologist Assistant under the medical supervision of a physician, may provide anesthesia services. Provider Qualifications Physician – Anesthesiologist Physician is defined as a doctor of medicine who is legally authorized to practice in the State in which he/she performs services. The issuance of a ... Read More

Obstetrical Anesthesia Documentation Providers billing codes 01958, 01960 – 01963, 01965, 01966, 01968 or 01969 for general anesthesia must document “start-stop” and total times on an attached anesthesia report only if the claim is for more than 40 units of time (10 hours).  Providers billing these codes for regional or both general and regional anesthesia ... Read More

Patient Controlled Analgesia Patient controlled analgesia (PCA) services are reimbursable when they are administered by an anesthesiologist and are performed for the control of postoperative pain. A separately identifiable physician-recipient encounter should be reflected in the medical record documentation. PCA pumps are usually administered through an intravenous (IV) line or the PCA pump is connected ... Read More

Consultations A consultation for anesthesia performed on the day of or days before a procedure is considered part of the global procedure and is not a separately reimbursable item. There are two exceptions to the above as outlined below. — A recipient with chronic intractable pain receives a consult from an anesthesiologist for the chronic ... Read More

Benefits and Limitations This section describes program-specific benefits and limitations. Verifying Recipient Eligibility, for general benefit information and limitations. Administration of anesthesia is a covered service when administered by or directed by a duly licensed physician for a medical procedure that is covered by Medicaid. Medical direction by an anesthesiologist of more than four Certified ... Read More

Qualifying circumstances. Anesthesia services, which are provided under particularly difficult circumstances, may warrant additional reimbursement for unit values based on unusual events. This subsection includes a list of important qualifying circumstances that impact the anesthesia service provided. These procedures are not reported alone but are reported as additional procedure numbers qualifying an anesthesia procedure for ... Read More

Postoperative Pain Management and Palliative Therapy Effective for services provided on or after July 1, 2001, postoperative pain management and selective palliative therapy provided by anesthesiologists are covered Medicaid services. Pain management must be related to the immediate post operative period or a catastrophic or terminal illness where palliative therapy is indicated. The Primary Care ... Read More