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Anesthesia Billing Experts

We have established a reputation as the leading provider in anesthesia billing. Our medical billing services are designed to accommodate the needs of anesthesiologists and CRNAs practicing anesthesia at private practices or as employees of hospital / surgery center facilities.

Services involving administration of anesthesia should be reported using the Current CPT anesthesia five-digit procedure code plus modifier codes. Surgery codes are not appropriate unless the anesthesiologist or Qualified Non-Physician Anesthetist is performing the surgical procedure. An anesthesiologist, Qualified Non-Physician Anesthetist or an Anesthesia Assistant (AA) can provide anesthesia services. The anesthesiologist and the Qualified Non physician Anesthetist can bill separately for anesthesia services they personally perform.

Here are three critical components for Anesthesia billing -

1. Anesthesia Specific Modifiers

There are several modifiers specific to Anesthesia which an experienced biller would know the best how to use them to ensure proper claim payment.Documentation modifiers (AA, QK, AD, QY, QX and QZ) must be billed in the first modifier field.If a QS modifier applies, it must be in the second modifier field. Processing delays and denials may occur for claims submitted without the modifiers in the current position.

2. Report Qualifying Circumstances

There are several qualifying circumstances that can be submitted to the insurance company if the services are deemed reasonable and necessary. The value of the additional codes is significant, and can mean higher payment for the anesthesiologist or CRNA. For example, reimbursement for +99100 Anesthesia for patient of extreme age, younger than 1 year and older than 70 (List separately in addition to code for primary anesthesia procedure) is 1 unit of anesthesia. If +99100 is left off, the physician does not receive the full reimbursement potential. Reporting of qualifying circumstances also leads to better documentation of the patient chart and improved compliance.

3. Append Physical Status Modifiers

Physical status modifiers are used for reporting the overall physical health of a patient at the time of a procedure or encounter, and can have a positive effect on the profitability of your facility.

A normal healthy person (units = 0)

A patient with mild systemic disease (units = 0)

A patient with severe systemic disease (units = 1)

A patient with severe systemic disease that is a constant threat to life (units = 2)

A moribund patient who is not expected to survive without the operation (units = 3)

A declared brain-dead patient whose organs are being removed for donor purposes (units = 0)

All insurers (except Medicare) allow physical status modifiers to receive additional total units of anesthesia reported for patients with higher risk factors or chronic conditions.

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