CPT codes

Conscious Sedation and Deep Sedation

by Niels
Conscious Sedation The intent of conscious sedation is for the patient to remain conscious and able to communicate during the entire procedure. The patient retains the ability to independently and continuously maintain a patent airway and respond appropriately to physical stimulation and/or verbal command. Conscious sedation includes performance and documentation of pre- and post sedation ... 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 provider reimbursement

by Niels
Payment at Personally Performed Rate The fee schedule payment for a personally performed procedure is based on the full base unit and one time unit per 15 minutes of service if the physician personally performed the entire procedure. Modifier AA is appropriate when services are personally performed. Payment at Medically Directed Rate When the physician ... Read More

How payment calculated for Anesthesia service?

by Niels
Payment Rules The fee schedule allowance for anesthesia services is based on a calculation that includes the anesthesia base units assigned to each anesthesia code, the anesthesia time involved, and appropriate area conversion factor. The following formulas are used to determine payment: • Participating Physician not Medically Directing (Modifier AA) (Base Units + Time Units) ... Read More

Payment for Multiple Anesthesia Procedures and Add-On Codes

by Niels
Multiple Anesthesia ProceduresPayment may be made under the fee schedule for anesthesia services associated with multiple surgical procedures or multiple bilateral procedures. Payment is based on the base unit of the anesthesia procedure with the highest base unit value and the total time units based on the multiple procedures with the exception of the new ... 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

What is Monitored Anesthesia Care?

by Niels
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 includes the performance ... Read More

Anesthesia Services and Teaching Anesthesiologist

by Niels
If 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 physical presence during only ... Read More

Pain Management post operative Anesthesia billing codes

by Niels
Pain Management Consultation Evaluation and management services for postoperative pain control on the day of surgery are considered part of the usual anesthetic services and are not separately reportable. When medically necessary and requested by the attending physician, hospital visits or consultative services are reportable by the anesthesiologist during the postoperative period. However, normal postoperative ... Read More

Anesthesia billing – GENERAL INFORMATION

by Niels
A Physician, a Certified Registered Nurse Anesthetist (CRNA) or Anesthesiologist Assistant under the medical supervision of a physician, may provide anesthesia services.Provider QualificationsPhysician – 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 license by a State ... Read More