Centralized Billing For Influenza Virus & Pneumococcal Vaccines

Centralized billing is a process in which a provider, who provides mass immunization services for influenza virus and pneumococcal pneumonia virus (PPV) immunizations, can send all claims to a single contractor for payment regardless of the geographic locality in which the vaccination was administered. (This does not include claims for the Railroad Retirement Board, United…

Medicare’s Standard For Anesthesia Coding Explained

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…

CPT 69436, CPT 69421, CPT 69433, CPT 69420 | Tympanostomy General Aneshtesia

procedure code and description 69436 –  Tympanostomy (requiring insertion of ventilating tube), general anesthesia  – average fee payment – $170 – $180 69420 Myringotomy including aspiration and/or eustachian tube inflation 69421 Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia 69424 Ventilating tube removal requiring general anesthesia 69433 Tympanostomy (requiring insertion of ventilating tube), local…

Anesthesia Billing Guidelines For CRNA’s

When filing claims through the Medicare program and the CRNA is employed by the anesthesiologists, reimbursement for “medically directed” by an anesthesiologist and “non-medically directed” are revenue neutral – meaning reimbursement is equal to the same amount.  For example, when medical direction modifiers “QK and QX” are reported (see table below), reimbursement is divided equally…

Services That Are Included In Anesthesia CPT & HCPCS Codes

Anesthesia HCPCS/CPT codes include all services integral to the anesthesia procedure such as preparation, monitoring, intra-operative care, and post-operative care until the patient is released by the anesthesiologist to the care of another physician. Examples of integral services include, butare not limited to, the following:• Transporting, positioning, prepping, draping of the patient for satisfactory anesthesia…

Biling & Coding Tips For Anesthesia CPT Codes

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…

Hospital & ASC Anesthesia Billing Explained

A majority of hospitals and ambulatory surgery centers are missing an opportunity to collect earned revenue associated with their anesthesia services. For example, a hospital performing 5,000 cases per year, could be missing nearly $1,500,000 per year. The evolution of the Outpatient Perspective Payment System (OPPS) continues to drastically change the landscape of healthcare reimbursement,…

Anesthesia Add On Codes | CPT 99100, CPT 99116, CPT 99135 & CPT 99140

Not reimbursed separately but should be billed when appropriate  99100 – Anesthesia for Patient of Extreme Age, Under 1 Year and Over 7099116 – Anesthesia Complicated By Utilization of Total Body Hypothermia99135 – Anesthesia Complicated By Utilization of Controlled Hypotension99140 – Anesthesia Complicated By Emergency Conditions Non-reimbursable Services Services billed by anesthesia assistantsServices provided by…