Wiki 62311?

nabernhardt

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may I ask how other facilities are charging/coding for when a CRNA does the ESI and no other provider is present. I am using the cpt code 62311 only. For profee our crnas are charging base units. However our insurance companies deny it as they are wanting an ASA code.
Thanks
 
are you sure they're actually performing the injection itself, or simply provider the MAC for the injection? If they're doing the injection itself then there are no "base units". Maybe the insurance company sees the base units and thinks that the CRNA is doing the anesthesia service, in which case they should be billing 01991/01992 depending on the position. if however the CRNA is doing the injection, then it would just be the 1 unit for 62311. and if there's no other provider in the room, who's providing the anesthesia? is the CRNA doing everything?
 
yes the CRNA is doing the actual injection. no other is present as part of the procedure. so can you clarify a little more on the 1 unit. And thats why I think the insurances are wanting an ASA code but I cannot use that 01991-01992 unless it is a different provider doing the injection which is not in this case.

THanks for your help.
 
Ok, not sure about how the anesthesia would be billed, if at all, but the procedure itself you would just bill the 62311 with 1 unit, assuming there was only one injection performed. If it was done in office (where all the equipment and supplies are owned by the company), then you could also bill for the drug, and if fluoroscopic guidance was used, 77003 along with any contrast that was used. not sure if there are reduced fees or modifiers for when a CRNA does it by themselves. that's a new one for me, never seen that before. hope this helps!
 
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