Question Anesthesia billing

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New to anesthesia coding and I have a question on billing the units or quantity. CPT is 01992 QZ, QS. Anesthesia time: Start 1412 End 1425 with total time being 13 minutes. Anesthesia is saying to bill 6 units. This procedure code has a base value of 5 units. How are they getting 6 units? Also, for CMS to pay for 01992 does there have to be a pre-operative evaluation, etc. Any help appreciated!
 

cgaston

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It has been a loooong time since I coded Anesthesia services, but I can answer the first part of your question:

Anesthesia services are calculated using Base + Time. You already know that the code has a base of 5, so we don't need to explain that part.

Time is calculated as one unit for every 15 minutes during the service (if your service is less than 15 minutes, you can bill 1 unit of time once you hit 8 minutes). This service lasted 13 minutes, which equals one time unit.

The code has a Base of 5 plus 1 Time unit = 6 units total. That is how they get the 6 billable units.


If the service lasted 30 minutes, you would have 2 time units: base 5 + 2 = 7 units.
If it lasted 41 minutes, you would have 3 time units.: base of 5 + 3 time = 8 units... make sense?
 
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