Anesthesia Billing from a patient's POV (Need Help) with some references.

[AB87]

I'm an OP Facility Auditor and haven't done Anesthesia coding in a long time. I will attach my son's bill. He had a Tibia Osteotomy (Bilateral) and on my bill I see 27705-AA ;27705-AA and on my insurance portal I only see 01484-QX. My question is since AA stands for Anesthesiologist performed it by himself should I only get one charge? (for the one CPT code since you would crosswalk it as 27705=01484-QX)

 

[AB87]

*****or should my bill be 01484-AA

 

[jkyles]

First: I hope your son is doing well. Second, QX means a CRNA performed the anesthesia under supervision of an anesthesiologist, so if 27705A indicates an an anesthesia service preformed by anesthesiologist, there's a conflict.

But yes, you should only be billed for a single anesthesia service even if the procedure was bilateral. I assume the lumbar epidural was for post-operative pain management, which would be reported with modifier 59 by the CRNA. If not, I'd wonder if it was mistakenly unbundled from the surgery.

 

[LisaAlonso23]

I would wait for the bill from the anesthesia provider.

 

[AB87]

First: I hope your son is doing well. Second, QX means a CRNA performed the anesthesia under supervision of an anesthesiologist, so if 27705A indicates an an anesthesia service preformed by anesthesiologist, there's a conflict.

But yes, you should only be billed for a single anesthesia service even if the procedure was bilateral. I assume the lumbar epidural was for post-operative pain management, which would be reported with modifier 59 by the CRNA. If not, I'd wonder if it was mistakenly unbundled from the surgery.

Thank you very much!

 

[AB87]

First: I hope your son is doing well. Second, QX means a CRNA performed the anesthesia under supervision of an anesthesiologist, so if 27705A indicates an an anesthesia service preformed by anesthesiologist, there's a conflict.

But yes, you should only be billed for a single anesthesia service even if the procedure was bilateral. I assume the lumbar epidural was for post-operative pain management, which would be reported with modifier 59 by the CRNA. If not, I'd wonder if it was mistakenly unbundled from the surgery.

Exactly! I didn't see the Epidural CPT. I am going to follow up with billing again because the entire claim was denied for coordination of benefits