Multiple Anesthetists Involved? Try These Tips
Question: How do I bill a procedure that is started by one anesthesiologist, but finished by a different anesthesiologist? Wisconsin Subscriber Answer: In this scenario, when both providers are billing under the same tax identification number (TIN), one claim will still be sent to the insurance, and the billing provider will be the anesthesiologist that was present for the longest portion of the case. This does not mean documentation isn’t important. Documentation should clearly show the time the first anesthesiologist began care, the time care was transferred, and the time the second anesthesiologist ended care. There should be continuous anesthesia care with no gaps in time. Most revenue cycle management (RCM) systems will allow entry of detailed start and stop times, as well as hand-off times. The same documentation principles apply if the anesthesia provider is a certified registered nurse anesthetist (CRNA) and is relieving another CRNA during the procedure. You should clearly document start and end times, as well as the hand-off time. It is best practice for like providers to relieve like providers. Or in other words, a CRNA only relieves another CRNA, and an anesthesiologist only relieves another anesthesiologist. It’s important to note that an anesthesiologist cannot relieve a CRNA that they are medically directing. Julie McDaniel, MHA, CPC, CANPC, Contributing Writer
