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Regs for time documentation requirements

  1. #1
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    Ellenville, New York
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    Default Regs for time documentation requirements
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    Hi everyone:

    I am looking for guidance to which regulations (CMS, JC and if possible, NYS Medicaid) as to what is required to be documented for the time billed. A question has come up if the hospital and professional times must match. Some (including me) don't believe so because the physician is still monitoring as the patient is in the recovery room, but some believe that since this would result in different times on the two claims, the claims would be rejected or denied. Any help is greatly appreciated.

    TIA!

  2. #2
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    I assume your talking anesthesia time? According to the 2009 Relative Value Guide page xvi:
    "Anesthesia time begins when the anesthesiologist begins to prepare the patient for anesthesia care in the operating room or in an equivalent area, and ends when the anesthesiologist is no longer in personal attendance, that is, when the patient is safely placed under post-anesthesia supervision."

    Hope this helps.
    Anna Weaver, CPC, CPMA, CEMC
    Associate Auditor

  3. #3
    Location
    Ellenville, New York
    Posts
    1,176
    Default Helps for MD
    Quote Originally Posted by Anna Weaver View Post
    I assume your talking anesthesia time? According to the 2009 Relative Value Guide page xvi:
    "Anesthesia time begins when the anesthesiologist begins to prepare the patient for anesthesia care in the operating room or in an equivalent area, and ends when the anesthesiologist is no longer in personal attendance, that is, when the patient is safely placed under post-anesthesia supervision."

    Hope this helps.
    Hi Ann:

    Thanks - that does help for the physician time - although I do need to determine what times are used for hospital/tech claims.

  4. #4
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    Do any other's bill by time? I thought anesthesia was unique as they were the only ones who billed on time.
    Sorry, I can't be more help.
    Anna Weaver, CPC, CPMA, CEMC
    Associate Auditor

  5. Default
    mnTwins,

    Are you billing for the anesthesiologist, or the hospital? I don't know anything about hospital, but I've been coding anesthesia for a large anesthesia billing practice for 8+ years and times on other provider's claims has never been an issue with any payor. The only times I have found that other provider's claims are considered is when the surgeon or hospital's claims contradict ours, but that is usually a code conflict, not time.

  6. Default
    I'm with hgolfos on this one. I've not had any problems with time being a problem on the claims relating to other providers. The only issues that I have had have been codes.

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