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Wiki Anesthesia billing

Community Wiki

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L
Hello to all,

I am seeking clarification, I am new to anesthesia coding and billing and need assistance.
When billing anesthesia for ASC physician and CRNA how to do I list modifiers on Medicare claim?

Do I list like the following : 00812-QX,QS,P3,PT FIRST LINE
99100 -QX,QS,P3,PT ( SECOND LINE) for the CRNA
AND

00812-QK,S,P3,PT
99100- QK,QS,P3,PT for the MDA


I am confused about how to list info on claims when billing MEDICARE for colonoscopy screenings that remain screenings and those that turn diagnostic.


Please assist :)

thanks in advance for any shared knowledge,
Leslie H

njbrown

Networker
Messages
25
Best answers
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Can someone tell me how to calculate anesthesia time for billing? This is new to me,I am being told you have a base rate then you multiply that by the number of units which are every 15 minutes.
 

CodingKing

True Blue
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3,814
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0
Reimbursement is Base Units + Time Units + Modifying units (if payer accepts them) * conversion factor

The base units per code is either by CMS Base Units or ASA RVG, depending on payer or contract.

Time units Number of minutes / 15. due to 50% time rule, if the remainder is under .5 round down. if the remainder is .5 or more round up
For instance 125 min = 8.33 since its not 50% into the next 15 minutes its considered 8 units
 
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