Wiki compliance issue broken medical direction

[elisaarb]

If case starts at 13:00 and ends at 15:00 with QK QX scenario to start....then QX leaves at shift end say around 14:00 would you bill QK & QX start time 13:00 end time 14:00 then bill for anesthesiologist alone AA start time 14:00 end time 15:00? If you have any experience with this scenario and have billed this way what repercussions entailed with reimbursement....did you have AA denied as duplicate or inclusive? Just curious how to go about billing for this one if it should occur...THANKS

 

[margsablan]

CMS and ASA clearly state that billable anesthesia time is continuous time with the patient. From a billing standpoint it is NOT APPROPRIATE to bill this time when the anesthesiologists or CRNA is not present with the patient. The anesthesiologist or CRNA should deduct any time away from the patient and report it as discontinuous time. If this is not done, anesthesiologists or CRNA could be charged with a false claim.

When it is necessary to have two anesthesiologists or one anesthesiologist and one CRNA (not medically directed by an anesthesiologist), which is highly unusual, EACH SHOULD REPORT HISH/ER SERVICES and send with a special report that lets the carrier know why this was medically necessary.[/SIZE]