Local by CRNA during a procedure

574coding

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Los Osos, California
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Hello,
I am a bit confused on how to bill this out.
Patient had a procdure (62323 LESI) at a ASC.
We have a CRNA that works for our company.
The CRNA saw the patient in pre op, did a pre anethesia H&P.
Went into the OR with the patient and per the anesthesia record monitored the patients EKG, SAO2, blood pressure, pt was on nasal cannula and was ready to step in if any problems.
How would you bill the CRNA care during this time, it was more than just the local.
Is this considered MAC?
Thank you
 
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Hi there, could you share some information about why the CRNA's services were used? It unusual for Medicare or private payers to cover anesthesia for epidurals because it is usually deemed unecessary If you bill it as MAC you can expect a denial and would need to demonstrate that anesthesia services (rather than half a valium) were necessary.
 

574coding

Guru
Messages
132
Location
Los Osos, California
Best answers
0
I think the CRNA was used due to safety for the patient. Prone position with risks and the provider doing the procedure felt this was in the best intrest of the patient.
Would you bill it as MAC?
I read the anesthesia record as "Local with monitored anesthesia care" by the CRNA due to the documentation on the report.
I was thinking code 01938.
I understand we may get a denial and would need to show proof of medical necessity. I just want to bill it correctly.
Thank you for you help with this.
 
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