Billing and coding tips

Ventilator Management anesthesia service payment from BCBS

by Niels
Anesthesia Payment & Billing Information – BCBS Ventilator Management in Conjunction with Anesthesia Services 94656 and 94657: Ventilation management billed on the same day as an anesthesia procedure is part of the global anesthesia service for the first 24 hours after anesthesia induction and therefore it is not billable. If procedure code 94656 is reported ... Read More

Biling and coding tip for anesthesia CPT codes

by Niels
CPT Anesthesia Code List00100–00222 Head00100 Anesthesia for procedures on salivaryglands, including biopsy00102 Anesthesia for procedures on plasticrepair of cleft lipCoding TipDo not use code 00102 for procedures performed onthe lip for conditions other than repair of cleft lip. Forother, non-cleft lip repairs, see code 00300.For cleft palate repairs, see 00172. 00103 Anesthesia for reconstructive proceduresof ... Read More

Concurrent Medically Directed Anesthesia 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

Billing for Anesthesia Services

by Niels
Claims Documentation Requirements  Submit claims for anesthesia services on the CMS-1500 claim form or the electronic equivalent. Use specific CPT American Society of Anesthesiology (ASA) anesthesia codes or surgical codes with the appropriate anesthesia modifier. For authorized surgical services, MHCP prefers that anesthesia services are billed using surgical procedure codes with the appropriate anesthesia modifier. ... Read More

Monitored Anesthesia Care (MAC)

by Niels
Monitored anesthesia care is a specific anesthesia service in which an anesthesiologist or CRNA has been requested to participate in the care of a patient undergoing a diagnostic or therapeutic procedure. Monitored anesthesia care includes all aspects of anesthesia care: a pre-procedure visit, intraprocedure care and postprocedure anesthesia management. During monitored anesthesia care, the anesthesiologist ... Read More

Anesthesia Medical direction guidelines.

by Niels
Criteria for Medical Direction Anesthesiologists can be reimbursed for the personal medical direction (as distinguished from supervision) that they furnish to CRNAs. Medical direction services personally performed by an anesthesiologist will be reimbursed only if the anesthesiologist: • Performs a pre-anesthetic examination and evaluation; • Prescribes the anesthesia plan; • Personally participates in the most ... Read More

What is base unit and Time unit

by Niels
Base Units Each anesthesia code (procedure codes 00100-01999) is assigned a base unit value by the American Society of Anesthesiologists (ASA) and used for the purpose of establishing fee schedule allowances.Anesthesia services are paid on the basis of a relative value system, which include both base and actual time units. Base units take into account ... Read More

Anesthesia Billing and coding

by Niels
Billing InstructionsClaims must be submitted on the claim Form CMS-1500 or electronic media claim equivalent.The following are specific to anesthesia claims submission:• Item 24D – the appropriate anesthesia modifier must be reported• Item 24G – the actual anesthesia time, in minutes, must be reported.ModifiersAnesthesia modifiers must be used with anesthesia procedure codes to indicate whether ... Read More