Wiki anesthesia for elective surgery

[Anna Weaver]

Help please!!! I have a patient who will be having an elective abdominoplasty that he has already paid for because he know's insurance will not pay for it. The question we have is:
He's also having another surgery at the same time for a mass removal in the sternum. Different surgeon will be performing, same surgery session. The anesthesiologist will be the same for both procedures.
Will insurance (anthem) pay for both procedures under anesthesiology, or will they carve out the time for the elective surgery, or will they deny both surgeries under anesthesiologist.
Any help would be appreciated. Thanks!

 

[aschaeve]

I am not sure if the insurance would pay for both surgeries. At the facility that I work, we will bill only the portion of the non elective surgery to the insurance. Ex. If the total time combined is 3 hours. Usually the surgeon for the elective surgery knows how long his time will take, say 2 hours. We will then only bill the insurance for 1 hour of anesthesia time and the 1 hour it takes the other surgery to perform his /her surgery. The rest is up to the patient to pay.

Hope this helps.

 

[jdrueppel]

We also "split bill" whenever there is a covered and a noncovered procedure during the same episode of care. Hopefully your provider clearly documented anesthesia times for each procedure.

Julie, CPC

 

[Anna Weaver]

anesthesia split surgery

Thank you both for your response. I will make sure our anesthesiologist documents his time clearly for both surgeries. Usually he does, he's one of the best for documentation I have seen. Very clear and concise. Thanks again!