Wiki Anesthesia auditing ?

halliot

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Pflugerville, TX
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Texas Medicaid allows all sorts of split billing Dr./ CRNA etc…. for delivery Anesthesia.
we have multiple claims where Anesthesia started as vaginal but went to a C section. So they start with 01967 and also bill 01968 with mod QY. The CRNA only helps with the C section so they bill only 01968 QX. The problem is 01968 is an add on code they can’t bill 01961 as that is C section only. Mind you with Medicaid they split the dollars for the 01968 code. So what to do with the CRNA bill do you allow them to bill the add on alone? Just curious if anyone else has seen this issue
thanks
 
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