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OB/GYN and Orthopedic Billing Anesthesia

  1. #1
    Unhappy OB/GYN and Orthopedic Billing Anesthesia
    Medical Coding Books
    Hi All,

    Can anyone tell me if OB/GYN and orthopaedic surgeons are allowed to bill anesthesia? I have some claims that have anesthesia being billed from these providers and I'm not sure if this is within their scope when it comes to billing for services. I would assume that for the anesthesia services, it would be handled and billed by the anesthesiologist and the provider (the OB/GYN or Ortho Surg) would bill only the procedure they performed.
    Please any help at all is appreciated!


    Pa Tang

  2. #2
    Default billing anesthesia
    You are correct. The anesthesia provider would bill the anesthesia codes and the physician performing the procedure would bill the surgical code. For example, surgeon does an arthroscopic medial meniscectomy and would bill 29881. Anesthesia would bill 01400 (plus time).

    OB might bill 59410 for delivery and postpartum care, anesthesia would bill 01967 for the labor epidural for the delivery.

    Hope this helps.


  3. Default
    It would help to know what types of anesthesia services they are billing for. For example, I know of an OB doctor who does his own epidurals for labor. He is qualified and bills for them. Need more info.

  4. #4
    NIENAJADLY: Thank you for your reply. Yes, what you said just confirms what I was thinking.

    hgolfos:Hi, and thanks for your reply. All the information I know is that the OB billed 00952 (ANESTH, HYSTEROSCOPE/GRAPH) and the orthopaedic surgeon billed 01630 (ANESTH, SURGERY OF SHOULDER).

    I'm not sure if these physicians are able to administer their own anesthesia but I would think that for these procedures, they wouldn't be able to do both the anesthesia code and the surgical code. Thanks.

  5. Default

    You're correct they shouldn't be billing for both anesthesia and surgery in the same operative session because billing the anesthesia code implies that they were providing full anesthesia services ie monitoring the pt etc. If they administered moderate sedation they can bill 99144 & 99145 along with the surgery, but they still have to have a qualified observer monitoring the pt. throughout.

  6. #6
    Thanks hgolfos!
    I just wasn't sure if OB/GYNs and orthopaedics could bill anesthesia at all. But what you said makes sense. The surgeon, himself/herself, would not be able to perform the procedure plus monitor the patient at the same time. Which doesn't make sense why these providers are attempting to bill for anesthesia.
    Thanks again!

    -Pa Tang

  7. Default
    You're very welcome! ;-)

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