Number of Units

[JCampbell]

I understand that anesthesia minutes are calculated by 15 increments. Can anyone tell me if you automatically round up to the next unit if it is 1 minute over the 15 minute increments?

Thanks
Jennifer

 

[MarieCoderII]

I don't do anesthesia coding but I found this info. I guess it depends on the insurance carrier. For example:

BC:
Anesthesia time should be submitted on the claim as total minutes. For example, 1 hour and 9 minutes of anesthesia time is billed as 69 minutes. Then converts minutes into 15-minute increments. If a fraction is left over (less than 15 minutes), this amount will be rounded up to the next 15 minute increment or to the nearest tenth time unit.

Medi-Cal:
Increments of time less than five minutes are not reimbursable except when the total anesthesia time being billed is less than five minutes. For more information, see “Total Anesthesia Time Unit: Less Than Five Minutes” in this section.

I hope this helps.

 

[mitchellde]

No the rule for timed codes is you must be 1 minute over half so you need to be 8 minutes over 15 to bill the next increment

 

[JCampbell]

Thanks for the help. Debra, was this rule taken from CMS website? I am having a hard time finding documentation stating this.

Thanks,
Jennifer

 

[mhstrauss]

http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf


Per Chapter 12, Section G:

"Actual anesthesia time in minutes is reported on the claim. For anesthesia services furnished on or after January 1, 1994, the A/B MAC computes time units by dividing reported anesthesia time by 15 minutes. Round the time unit to one decimal place. The A/B MAC does not recognize time units for CPT codes 01995 or 01996."



I'm not familiar with anesthesia, but I'd remember seeing this before; hope this helps some