Answer anesthesia question regarding time

rockylopez

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Good morning. I wanted to reach out in the forum. I am doing research on cataract surgery anesthesia. The physician works with a CRNA and his start and stop time has been overlapping. I am trying to do research to see if this is billable. His major payor is Medicare. I found information online that states that you can only have up to four concurrent cases per day. If anyone if familiar with anesthesia coding please let me know.
Thank you
 
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Hi there, this looks like a question about medical direction. When you say the start and stop times are overlapping do you mean the physician's time is overlapping with the CRNA, another case they are medically directing or services that they are performing...?

At any rate, when medically directing CRNAs a physician can medically direct a total of four cases at a time (not per day) and that applies to all patients (private pay, Medicare, Medicaid etc).

If you're new to anesthesia coding I highly recommend reading all of sections 50 and 140 here: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf and chapter 2 of the NCCI manual https://www.cms.gov/files/document/chapter2cptcodes00000-01999final11.pdf.
 

rockylopez

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Thank you very much it is very much appreciated. I am new to anesthesia coding and the provider is new with our company. He works with the CRNA and the cataract surgery times are overlapping. For example he performs 20 cases in a day and all of his anesthesia start and stop times overlap. In our billing system it gives up an option to select yes under concurrency and currently right now it is under "no" category. I believe if the times are overlapping concurrency should be under "yes".
Thank you again :)
 
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