Results 1 to 4 of 4

Medicare Rules for Anesthesia

  1. #1
    Modesto, CA; Central Valley Chapter
    Default Medicare Rules for Anesthesia
    Medical Coding Books
    We received a denial stating Medicare does not allow span code billing. I am assuming they mean that when a surgery passes midnight that they do not accept the two dates for the surgery. However I cannot locate any reference as to how they want it billed.

    I am in No Ca and Palmetto is our carrier; I can't find anything on their site.

    Does anyone know how to find this information on their website or have a link to it?


    Tina Reich, CPC, CPC-I, CEMC

  2. Default
    I do billing for anesthesia in florida and we bill with QK QX. What procedure did you bill for because time is everything with anesthesia. And are you making sure you are using military time?
    Last edited by dbutler593; 08-24-2009 at 09:24 PM.

  3. #3

    I can't find anything in the CMS manual but I always billed anesthesia services under the starting date of service. I think Medicare requires this (although not specified) because they pay the claim based on total minutes and not the actual start/stop times. Therefore, when an anesthesia claim comes in it is already reflecting multiple units (due to reporting of minutes) and then will error out when multiple dates of service are indicated. I know this is not the written regulation you are asking for but I thought I'd share my understanding of the CMS logic on the situation.

    Julie, CPC

  4. #4
    Our Medicare carrier (NHIC) indicated that while they can accept a claim w/span date it would automatically trigger a request for medical record and explanation of post-midnight anesthesia. NHIC also indicated for Post midnight anesthesia that it would be acceptable to bill using the start date as the start and end date (although our system can not support). Good luck.

Similar Threads

  1. Medicare Colonoscopy Rules
    By GSCoder07 in forum Gastroenterology
    Replies: 6
    Last Post: 06-20-2011, 10:51 AM
  2. Opting out of Medicare Rules
    By Barbaraw in forum Compliance General Discussion
    Replies: 0
    Last Post: 12-02-2010, 11:08 AM
  3. new medicare rules
    By jennyjlm in forum E/M
    Replies: 1
    Last Post: 02-09-2010, 12:30 PM
  4. Medical Assistance rules for Anesthesia Billing
    By scannon in forum Anesthesia
    Replies: 6
    Last Post: 10-20-2009, 08:23 PM
  5. Medicare's rules??
    By poohdp01 in forum Medicare Regulations
    Replies: 5
    Last Post: 08-30-2009, 07:32 AM

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.