This article explains anesthesia billing with guidelines and official definitions. The following services are included in general anesthesia administration; administration of fluids and blood; preoperative and postoperative visits; usual monitoring (for example, blood pressure, ECG, temperature, oximetry, mass spectrometry, or capnography) as defined by ASA (American Society of Anesthesiologists) and/or CPT coding guidelines; and anesthesia…
ANESTHESIA REIMBURSEMENT METHODOLOGY Code Description Comments 01960 Anesthesia for vaginal delivery only Bill when no neuraxial/anesthesia is involved with vaginal delivery; not reimbursed with 01967 01961 Anesthesia for Cesarean delivery only Use to report anesthesia services…
Below the descriptions and billing guidelines for CPT 01960, CPT 01961, CPT 01967, CPT 01968 and CPT 01969. Click on a link to go to that section of the article. CPT 01960 Procedure Billing Guidelines CPT 01961 Procedure Billing Guidelines CPT 01967 Procedure Billing Guidelines CPT 01968 Procedure Billing Guidelines CPT 01969 Procedure Billing Guidelines…
Intra-operative monitoring by an anesthesiologist, physician, or other qualified individual under the medical direction of the anesthesiologist, of the patient’s vital physiological signs in anticipation of the need for administration of general anesthesia or of the development of adverse physiological patient reaction to the surgical procedure. MAC is eligible for coverage when performed by the…
Anesthesia Modifiers Modifiers are two-digit indicators that are used with a procedure code to add specific meaning to a service provided. Every anesthesia administrative code billed to BCBSF must include a modifier. More than one modifier can be submitted per detail line; however, the BCBSF claims system will adjudicate the claim based only on the…
The following modifiers should be used as secondary or tertiary modifiers only and not as the primary modifier. These modifiers are intended to provide additional information specific to the services provided; there will be no additional reimbursement made for these modifiers. Modifier Description 22 Increased Procedural Service — Per CPT Appendix A modifiers: When the…
Intravenous medicines for anesthesia Intravenous (IV) anesthetic medicines are given into a vein. They can be given quickly and are rapidly absorbed into the blood. IV anesthetics are used to relieve pain (analgesia), to relax (sedate), to induce sleepiness (hypnosis) or forgetfulness (amnesia), or to make you unconscious for general anesthesia. Most IV anesthetics cannot…
Anesthesia and E/M services Anesthesia services are billed using CPT® codes 00100-01999. These CPT® codes are cross-walked to surgical codes. The crosswalk is available from the American Society of Anesthesiologists at www.asahq.org. Each anesthesia code has a base unit assigned to it. The anesthetist also bills the number of time units, with a single unit…
Post-Operative Pain Management and Epidural Catheters Surgeons routinely provide necessary post-operative pain managementservices and are reimbursed for these services through the global surgeryfee. The surgeon should manage post-operative pain except underextraordinary circumstances. Procedures involving major intra-abdominal,vascular and orthopedic, and intrathoracic procedures will be covered forpost-operative pain management by an anesthesiologist when medicallyindicated. Postoperative pain management…
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…
