Wiki Multiple surgery reduction anesthesia provider in same group

[betsycpcp]

If an anesthesia bill includes a nerve block such as 64415, and the surgeon is in the same group practice (large hospital group), is it normal for the surgeon's primary procedure to be paid at a reduced rate as if it's a secondary procedure when the nerve block happens to be submitted and paid first? I understand if they actually work in the same practice that the different doctors may be treated as if they're the same person for reimbursement purposes, but it doesn't seem right that a bill from the anesthesiologist that includes 64415 would be treated as primary and cause a reduction in the surgeon's bill. Just wondered if this is usually done. This was Ohio workers' comp but I wonder if other payers do it this way.

 

[csperoni]

As long as the two providers are not the same specialty, there should not be a reduction in the the other physician's bill. If the physicians are the same specialty and same group, then claims would be processed as though it was one provider.
I've never seen a reduction to a surgeon's bill due to anesthesia bill, but also never dealt with Ohio WC.

 

[betsycpcp]

As long as the two providers are not the same specialty, there should not be a reduction in the the other physician's bill. If the physicians are the same specialty and same group, then claims would be processed as though it was one provider.
I've never seen a reduction to a surgeon's bill due to anesthesia bill, but also never dealt with Ohio WC.

Thank you, that makes sense to me, so it may be a problem on WC's end.