Are you asking from a payer or provider stand point? Not that it matters but by the way you pose the question it would appear you are a payer.
It depends on how the service is billed. MDAs can personally perform, medically supervise, or medically direct. CRNAs can personally perform (if allowed by state where service was performed CRNA licensure scope of service), be medically supervised or be medically directed. It comes down to the documentation, concurrency and the modifier reported on the services. See HCPCS modifiers AA, AD, QZ, QX, QK, QY. The CMS manual has a description of each of these billing scenarios as well as % of payment guidelines that apply to each modifier. I have attached to CMS Anesthesia Chapter link below. See page 117.
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join