Revenue Cycle Insider

Question: I’m reporting radiologic anesthesia services performed on a Medicare beneficiary and running into obstacles getting the services reimbursed. Can a provider report both an anesthesia code and a radiological supervision and interpretation code for the same encounter?

Alabama Subscriber

Answer: The Centers for Medicare & Medicaid Services (CMS) offers specific rules and guidelines for coverage and reimbursement, including for anesthesia and radiologic anesthesia services.

There are a few things you need to know:

• Guidelines allow only one anesthesia code to be reported in conjunction with radiological procedures, even if more than one radiological procedure is performed during an encounter.

• Reporting radiological supervision and interpretation (RSI) codes may be appropriate, but they are not included in the anesthesia codes and cannot be reported by the provider supplying/reporting the anesthesia service.

• An anesthesia provider may be able to report moderate conscious sedation services separately for a medical or surgical procedure unless the anesthesia service is bundled into that procedure, like in radiation treatment management.

• For radiologic procedures that involve a catheter, as well as a same-site catheter for monitoring purposes, it’s inappropriate for either the anesthesia provider or the procedure-performing physician to report the placement of the monitoring catheter separately.

So, if you’re reporting the anesthesia services, you shouldn’t report the RSI codes for that provider as well.

Of course, check with your respective Medicare Administrative Contractor (MAC) to make sure you’re following any appropriate coverage determinations, too.

Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC