Anesthesia Billing FAQs

Anesthesia Billing FAQs


Anesthesia Billing Setup

How do I set up Anesthesia Billing?


Anesthesia Billing Resources


Concurrency

Why is Anesthesia billed using Concurrency?

  • Concurrency Reports are necessary for Anesthesia services that are provided by CRNAs.
  • Many states require CRNAs to be medically directed or supervised by an Anesthesiologist.
  • Concurrency Reports determine the correct Provider Modifier that should be billed and if the Claim should be split by Line or by Claim.


MAC

What is MAC Anesthesia?

  • Modified Anesthesia Care (MAC): A light sedation where the Patient is still under Anesthesia but is generally still awake and semi-aware.


Medically Directed Encounters

How do I bill two Encounters if there are two or more Medically Directing Providers and CRNAs?

Example: The Patient had 2 Medically Directing Providers and 2 CRNAs. The Anesthesia start time is 7:43, and the end time is 12:48.

  • 7:43-10:43 (180 min): MD 1 and CRNA 1
  • 10:43-11:19 (36 min): MD 1 and CRNA 2
  • 11:19-12:48 (89 min): MD 2 and CRNA 2

Encounter 1: Originating Encounter

  • Claim Level
  • Billing Provider: Medically Directing Provider 1
  • Rendering Provider: CRNA 1
  • Line 1
  • CRNA 1
  • MD 1
  • Start/end time (7:43-10:43)
  • Line 2
  • CRNA 2
  • MD 1
  • Start/end time (10:43-11:19)
  • Line 3: This line needs to be Split.
  • CRNA 2
  • MD 2
  • Start/end time (11:19-12:48)

Encounter 2: Split Encounter

  • Claim Level
  • Billing Provider: Medically Directing Provider 2
  • Rendering Provider: CRNA 2


Modifiers

What are the Medically Directed Anesthesia Modifiers?


Pending Finalization 

 What is Pending Finalization? 


Split

Can I fix a Claim that was not split due to an error in Charge Entry?

  • If the Charge is in an Open Period:
  • Attach to the original Reference Batch.
  • Make all corrections on the Modify Charge screen.
  • Run the Concurrency Report with the DOS range and Finalize.
  • If the Charge is in a Closed Period:
  • Attach to a Reference Batch.
  • Encounter Dashboard > Reverse Charge
  • Reverse for Modification and make corrections on the New Encounter.
  • Make the corrections on the New Encounter.
  • Run the Concurrency Report with the DOS range and Finalize.

Surgeon

Can a Surgeon bill for Anesthesia?

  • A Surgeon cannot bill for Anesthesia at the same time that they are performing surgery.


Time Units

How do I set up Anesthesia Time Units?


Visit Concurrency

How do I set up Anesthesia Visit Concurrency?


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