Wiki Anesthesiologists billing the actual surgical code

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sfoti

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Does anyone know if it is acceptable for anesthesiologists to bill for the actual surgical code with minutes and units and any appropriate anesthesia modifiers? I have been in an argument about whether this is acceptable or not. I would appreciate any input.
Thank you
Sandy Foti
 
If you're talking about billing for anesthesia services we have some commercial insurance payers who still prefer/accept the CPT code with minutes of anesthesia and/or units of service. The reasoning I've been given is that they need the anesthesia claim coding to match the surgeon's coding to ensure proper payment. Most payers, however, prefer the ASA code.

My billing system gives me either option and, for reporting purposes, we enter the all charges with the CPT codes and my billing program references the appropriate coding billing guideline as I have set up in the insurance file maintenance.

Julie, CPC
 
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yes I was talking about anesthesia services. So this practice is based solely on payor preference? Thank you for your response.
Sandy
 
Yes, I'd say the norm is the submission of the ASA code but it is not inappropriate for a payer to request the CPT code if it is what is necessary for them to process the claim.

Julie, CPC
 
Billing 00142 and 66984 surgery code together

Hello,
I have a similar question. An anesthesia group is billing both the 00142 and 66984 and getting paid for both. That would be incorrect, right?
 
Are both charges for professional services? I can't think of a reason to be billing both codes unless it is a payer specific billing guideline and and even then it's not making sense to me. For most payers (i.e. Medicare or UHC) if they are billing both codes it would not be correct. Remember, just because you get paid for something does not make it correct.

Julie, CPC
 
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