Wiki Surgical CRNA in Michigan

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maggieklop

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The hospital where I code for Cardiothoracic surgeries has recently had our PA assistant surgeon retire, and are adding two assistant surgeons for coverage until we find someone permanent. One of the individuals is a CRNA, how am I to bill their services? Would it be the same as the PA who is leaving? Add an AS modifier, or are we not to bill for them? My senior financial analyst suggested seeking advice @ the AAPC. If anyone can help, I would appreciate the advice. Thank you.
 
From a coder's perspective, a CRNA is a clinical nurse specialist and -AS is the appropriate modifier.
From a host of other perspectives, which a coder is typically not qualified to answer:
A CRNA is a clinical nurse anesthetist - specialized training to administer and manage anesthesia care, not for surgical procedures.
1) Does the scope of practice in your state allow a CRNA to first assist at surgeries?
2) Does the hospital permit your CRNA to first assist?
3) Do your insurance contracts allow credentialing for CRNA?
4) Does the malpractice coverage for your CRNA cover assistant at surgery?
 
This is not a decision a coder should be making at this point. It also depends on if you are talking about the facility or professional fee side. This is something the management and C-levels would need to be making decisions on. Are they just temporary fill-ins? Employees? Contractors? Should you even be submitting claims for them?, etc. Along with the questions Christine listed above.
 
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