Anesthesia Coding Alert

Question: I have doubts regarding flat fee calculation. My client calculates time using 11-minute units, not the standard 15- minute units. I haven't seen any examples like this in the ASA guidelines. What should I do?Indiana SubscriberAnswer: Flat fee services are just that -- one fee for the service. CMS processes using 15-minute units. A few companies still allow 10-minute units, but most use the CMS 15-minute-unit policy.Fifteen-minute increments are the most commonly used with carriers such as Medicare and Medicaid. These are mandated, meaning that your client doesn't have a choice unless they don't participate in those programs.Although some private insurance companies have followed suit and pay in 15-minute increments, your client is not required to report time in 15-minute increments unless they have a contractual agreement.Remember: The ASA RVG (Relative Value Guide) indicates that time is calculated "as is customary in your geographical area." This is because anesthesia time-unit calculations can [...]