Wiki Anyone billing anesthesia for CRNAs in Massachusetts?

[jhaines]

I am posting this for a coworker, as I have limited knowledge of anesthesia billing. We have a new client who uses CRNAs for anesthesia. I am hoping someone has some insight on these issues:

**For medically directed CRNA, Tufts Health Plan requires the anesthesiologist and the CRNA to bill on the same HCFA. Wondering how to do it and what the HCFA would look like?

**If the CRNA is new and not yet credentialled, but the anesthesiologist is credentialled, can we bill the physician portion and hold the CRNA portion until credentialled?

Just wondering what the HCFA should look like when billing for a medically directed CRNA - anyone have any information/resources?

Any help is greatly appreciated!

 

[CodingKing]

I work for a health plan in MA but not Tufts. Ive been seeing them come in both ways. Separate form for CRNA and MD. For those that come in with both on 1 form i don't see any reference to the CRNA's name. The MDs name is in the signature area of the claim. The MDs NPI is on box 24J on service line 1. CRNA service is on line 2 w/ CRNA NPI in 24J. I don't know about the provider enrollment process at Tufts but i assume its the same all over the state (or just states that use CAQH?) that Pathology, Anesthesiology (excl pain mgt), Radiology & Emergency Medicine provider don't need to be credentialed just enrolled.

Thanks for bringing this up. I'm going to suggest to our payment policy committee (that i'm now a member of since i became a certified coder ) that we move to the single claim form for MD + CRNA. It will cut down on a lot of the claim pending due to provider enrollment issues (groups forgetting to update their roster, PHO/IPA that don't acknowledge Midlevels, etc)