Anesthesia claim payment process

Anesthesia claims are paid based on the following:  Time units + Base unit x Anesthesia Conversion factor. Neighborhood uses the Centers for Medicare and Medicaid Services (CMS) base unit values. · Anesthesia Personally Performed by Anesthesiologist or CRNA (AA or QZ Modifier) (Total Time Units + Base Unit) x Anesthesia Conversion Factor x Modifier Adjustment ... Read More

Definition of Concurrent Medically Directed Anesthesia Procedures with time calculation example

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 these other procedures overlap each other. Concurrency is not dependent on each of the cases involving a Medicare patient. For example, if an anesthesiologist directs three concurrent procedures, two ... Read More

billing anesthesia time units – calculation for personally performed and Medical direction

Anesthesia Payment & Billing Information Time and Points Eligible Anesthesia Procedures Defined Blue Cross and Blue Shield of Texas has determined that certain anesthesia procedures will be reimbursed on time and points methodology. Procedures  that  are   not  included  on  the   Anesthesia  Time  &  Points Eligible List will not be reimbursed using time and ... Read More

Anesthesia Time and Calculation of Anesthesia Time Units

Anesthesia time is defined as the period during which an anesthesia practitioner is present with the patient. It starts when the anesthesia practitioner begins to prepare the  patient for anesthesia services in the operating room or an equivalent area and ends when the anesthesia practitioner is no longer furnishing anesthesia services to the patient, that ... Read More

Aneshthesia Time-Based Units

During the first 4 hours of service, 15 minutes equals 1 unit. If services are provided for longer than 4 hours in one occurrence, each 10-minute period after the initial 4 hours equals 1 unit. A period less than a unit should be rounded up to the next unit.  Example A: 5 hours or 300 ... Read More