Results 1 to 3 of 3

Can ortho surgeon charge for administering anesthesia?

  1. Default Can ortho surgeon charge for administering anesthesia?
    Medical Coding Books
    If the doctor does a case without an anethesiologist, is he able to charge for the administering of a metacarpal block or IV regional block? I have a doctor that wants to start charging for these.

    Thank you!!

  2. #2
    Albany, New York
    Yes, according to CPT your physician can code/ charge for this.
    Review the Anesthesia Guidelines in the front of that section in the CPT book.
    Karen Maloney, CPC
    Data Quality Specialist

  3. #3
    Default HOWEVER.....CCI Edit state Different.
    CCI Editing states that the provider that performs the service can not bill for anesthesia... Per the CCI Edit by CMS... (Cut and Copied) the anesthesia is included in the medical/surgical package. "Local anesthesia including local infiltration, regional blocks, mild sedation, and all other anesthesia services except moderate conscious sedation reportable as CPT codes 99143-99145 are not separately reportable by a physician performing a medical or surgical procedure". This is ALSO stated in your CPT book in the surgery guidelines section.
    CCI edits also state: Medicare Anesthesia Rules prevent separate payment for
    anesthesia services by the same physician performing a surgical
    or medical procedure. The physician performing a surgical or
    medical procedure should not report CPT codes 90760-90775 for the
    administration of anesthetic agents during the procedure. If it
    is medically reasonable and necessary that a separate provider
    (anesthesia practitioner) perform anesthesia services (e.g.,
    monitored anesthesia care) for a surgical or medical procedure, a
    separate anesthesia service may be reported by the second
    Under the CMS Anesthesia Rules, with limited exceptions, Medicare
    does not allow separate payment for anesthesia services performed
    by the physician who also furnishes the medical or surgical
    service. In this case, payment for the anesthesia service is
    included in the payment for the medical or surgical service. For
    example, separate payment is not allowed for the physician's
    performance of local, regional, or most other anesthesia
    including nerve blocks if the physician also performs the medical
    or surgical procedure. However, Medicare may allow separate
    payment for moderate conscious sedation services (CPT codes
    99143-99145) when provided by same physician performing the
    medical or surgical procedure except for those procedures listed
    in Appendix G of the CPT Manual.
    I work for an insurance co. and would not pay a physicain for performing his own anesthesia due to the CMS based edit above....

Similar Threads

  1. ASC/Anesthesia/Surgeon billing
    By mwagone1 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 12-28-2013, 12:44 PM
  2. anesthesia with ED charge
    By apollo06 in forum Anesthesia
    Replies: 0
    Last Post: 10-16-2013, 01:34 PM
  3. charge for administering injections
    By ddebbied in forum Modifiers
    Replies: 2
    Last Post: 07-07-2011, 07:45 PM
  4. Surgeon doing anesthesia?
    By LindaEV in forum General Surgery
    Replies: 0
    Last Post: 11-05-2010, 11:10 AM
  5. Can Ortho. charge for setting FX at a school?
    By LynnS.321 in forum Orthopaedics
    Replies: 2
    Last Post: 09-23-2008, 12:22 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.