Wiki Bundling question

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cingram

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I work for a group of anesthesiologist. We provided anesthesia services for a pain management doctor who billed out 64490. We billed out 01992. The insurance recouped our payment saying it is bundled with 64490. I thought since we are 2 separate doctors in separate offices and different TaxID that this should not be bundled. Please advise
 
You are correct - by my understanding, anesthesia should only bundle to the surgery if it was administered by the surgeon. If your anesthesiologists did not perform any other procedures for this patient on this date, then this must be a payment error by the insurance company.
 
Don’t have my book handy but I think the asa for 64490 is 01936. Also, many payola require 2 comorbidities and/or a p3 risk to justify medical necessity for separate anesthesia.
 
same day bundlie

Hello, (I meant bundle)
My office has been receiving numerous claims where we bill with 77065 and G0279 and they pay only on the G0279 and bundle 77065 to it. We never had any issues with it being paid before. Any suggestions?
 
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Do you happen to have experience with code 64483 being billed by facility and administering doc (pain management) and CRNA billing 01992 with QZ modifier? Three separate claims. CRNA is only monitoring vitals with no anesthetic given. Max of 10 min. The CRNA does do a pre-op consult. Would this be wrong to bill out for anesthesia code when only vitals are being monitored by the CRNA?
 
lklokner said:
Do you happen to have experience with code 64483 being billed by facility and administering doc (pain management) and CRNA billing 01992 with QZ modifier? Three separate claims. CRNA is only monitoring vitals with no anesthetic given. Max of 10 min. The CRNA does do a pre-op consult. Would this be wrong to bill out for anesthesia code when only vitals are being monitored by the CRNA?
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I answered your question in your other post.
 
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