1. Principles of Medicare coding for anesthesia services involving administration of anesthesia are reported by the use of the anesthesia five-digit CPT procedure codes (00100-01860). These codes specify “Anesthesia for” followed by a general area of surgical intervention. Subsequent CPT codes (01905-01933) are unique to anesthesia for interventional radiology. SeveralCPT codes (01990-01999) describe miscellaneous anesthesia…
Anesthesia Payment & Billing Information – BCBS Payment Calculation InformationTime Units :Time units will be determined by using the total time in minutes actually spent performing the procedure. Fifteen minutes is equivalent to one (1) time unit. Time units will be rounded to the tenth. Therefore, if the procedure lasted 49 minutes, the time units…
Consultations A consultation for anesthesia performed on the day of or days before aprocedure is considered part of the global procedure and is not a separatelyreimbursable item. There are two exceptions to the above as outlined below. − A recipient with chronic intractable pain receives a consult from ananesthesiologist for the chronic intractable pain, or…
Medical Direction & Temporary Relief CRNAs/AAs providing anesthesia services under the medical direction of an anesthesiologistmust have uninterrupted immediate availability of an anesthesiologist at all times. When amedically directing anesthesiologist provides temporary relief to another anesthesia provider, theneed for uninterrupted immediate availability may be met by any of the following strategies: • A second anesthesiologist,…
Medi-Cal has not adopted the “qualifying circumstances” codes (99100 – 99140). Claims submitted with these codes will be denied or returned to the provider for correction. Billing Anesthesia Services Anesthesia services (CPT-4 codes 00100 – 01999) are reimbursed when medically necessary. To bill for anesthesia services, use the five-digit CPT-4 code applicable to the procedure…
1.Multiple Procedures. When multiple surgical procedures are performed during a single anesthetic administration, report only the anesthesia procedure with the highest unit value. The time reported should be the combined total for all procedures performed. 2. Anesthesia Modifiers. Physical status and common CPT modifiers used in conjunction with anesthesia codes can be found in 114.3…
Add the appropriate Level 1 or Level II CPT modifier to the five digit code or identify the modifier by use of a separate code by adding 099 before the 2 digit number e.g. 09950, 09951. Level 1 Modifier Description -59 Distinct Procedural Service The modifier –59 is appropriate to report multiple service submissions for…
ANESTHESIA SERVICES Medical and Surgical Services Rendered in Addition to Anesthesia Procedures Payment may be made under the fee schedule for specific medical and surgical services by theanesthesiologist as long as these services are reasonable and medically necessary or providedother rebundling provisions do not preclude separate payment. These services may be renderedin conjunction with the…
