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Anesthesia Time on Claims Question

Melissa-ASL-PMB-07

Networker
Messages
94
Location
Richmond, IN
Best answers
0
This Maybe an Odd Question:
I have been coding for anesthesia for almost 12 years and we always report the anesthesia start and stop times with total time in minutes noted on the claim.
We also report the minutes in the required field.

My question is: Is this necessary for payment? Are we wasting production time by always providing this information?

I have seen one source specifically state the start time and end time is to be reported on the claim.
However, all other sites I have scoured just say the CMS statement of how the time must be reported in actual minutes.

I only ask because we recently took over billing for a client and were reviewing older claims that nothing had the anesthesia times on, but they were paid!

This was shocking to me.
Thanks for your feedback! :eek:
~Melissa, CPC
 

pscanlan

Networker
Messages
51
Best answers
0
Minutes are used to calculate units, which get multiplied by some base charge per unit to get the billed amount. IIRC 15 minutes = 1 unit. Most payers reimburse based on how many units were submitted on the claim, but I suppose it's possible that someone out there is calculating reimbursement down to the minute. We put the minutes on more for completeness than anything, in case the payer wants to check our math.

I don't know about your setup, but our billing software takes the time segments we put in and calculates the units for us. Only the units are necessary on the claim, I think. But the time segments are a concrete data point that can at least be independently verified by the facility or surgeon through their respective records. I haven't worked on the payer side, but I have to imagine for surgical procedures under anesthesia, they're comparing the surgical OP note to the anesthesia OP note for consistency/inconsistency on a fairly regular basis.

It might cut down on denials to include time. I'm not brave enough to take the time segments off for a few claims to find out for sure though.
 
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