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Thread: Medicare Rules for Anesthesia

  1. #1
    Join Date
    Apr 2007
    Modesto, CA; Central Valley Chapter

    Default Medicare Rules for Anesthesia

    AAPC: Back to School
    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. #2


    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
    Join Date
    Apr 2007
    Lincoln, NE



    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
    Join Date
    Apr 2007


    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.

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