Anesthesia and Pain Management - claiming that CPT

cronicizo

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I'm getting denials to my Anesthsia claims claiming that CPT 01992 MOD QZ is included or incidental in the physicians' professional charges for facet injections when they are obviously billed on separate claims and are separate entities. Can anyone give some insight on how to appeal this? :confused:
 

dwaldman

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Is the carrier Aetna? They have sent us a memo that they sent providers stating that for certain pain procedures, anesthesia would be included even if performed by a separate CRNA or Anesthesiologist. Without doing a written appeal, you might be able to call on the phone and stressed if they have policy on this and if they can forward it to you.
 

dwaldman

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I will have check with a lady at the business office I work at, if she is able to appeal this or if she is writting them up to take the carrier's suggested adjustment.
 
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