When to use Modifier 59, 73, 74 IN Anesthesia billng?

59 Distinct Procedural Service — Services with modifier 59 may be subject to review of medical records. Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day. Modifier 59 is used to identify procedures/services, other than E/M services, ... 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

Billing and Payment for Multiple Anesthesia Procedures

Physicians bill for the anesthesia services associated with multiple bilateral surgeries by reporting the anesthesia procedure with the highest base unit value with the multiple procedure modifier “-51.” They report the total time for all procedures in the line item with the highest base unit value. If the same anesthesia CPT code applies to two ... Read More

Payment at the Medically Directed Rate

The Part B Contractor determines payment for the physician’s medical direction service furnished on or after January 1, 1998, on the basis of 50 percent of the allowance for the service performed by the physician alone. Medical direction occurs if the physician medically directs qualified individuals in two, three, or four concurrent cases and the ... Read More

BCBS claim filing limit for Anesthesia claims

Claim Filing Effective for dates of service on or after January 1, 2014, Blue Cross requires claims for anesthesiologists, CRNAs and AAs to be billed under the name and National Provider Identifier (NPI) of the provider who  actually rendered the service. Blue Cross does not recognize “incident to” billing for anesthesia services. All providers should ... Read More

Regional Anesthesia CPT code 01967, 01968 and 01969

Topical anesthesia, local, local infiltration and/or metacarpal/digital block, is included in the basic allowance of the surgical procedure performed. No additional reimbursement is provided. • Nerve Blocks -A nerve block involves the injection of a peripheral nerve into or around a given site. If the anesthesiologist administers the injection or block postoperatively in an area ... Read More

Anesthesia During Delivery CPT codes 01967, 99140,

Labor Epidurals Anesthesia for labor epidurals are time-based services and should be billed as total minutes. CPT code 01967: Neuraxial Labor Analgesia/Anesthesia for Planned Vaginal Delivery This includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor.)  Code may be reported as a single anesthesia service. ... Read More