Anesthesia Visit Concurrency

Anesthesia Visit Concurrency


Anesthesia Visit Concurrency

Concurrency occurs when an anesthesiologist is medically directing or medically supervising the work of one or more anesthesia professionals.

  • The appropriate billing modifier is determined by the maximum number of cases the anesthesiologist is supervising during any single minute of the procedure.
  • The Concurrency modifiers are set up in Anesthesia Time Units.
  • For the system to calculate concurrency properly, ALL charges for the date of service MUST be entered.


For the Concurrency report to work, a few items must be in place:

  • Admin > Anesthesia Time Units:  each setting must have the Claim Split setup and, where applicable, the Service Line Recalculation selected (determined by payer guidelines)
  • Libraries > Billing Rendering Provider: Each Provider must have their credentials set.  These credentials are used to determine what type of split claim will be done, as well as, which "Provider" Modifiers will be used on the split claims.
  • Each encounter must have a CPT line with a Start and End Time.  Without a start and end time, the Encounter will not be included on the Concurrency report and will not be split.
  • Max Concurrency Rule: When a Provider medically directs more than one Case at a time, the Max Concurrency Rule would apply. Max Concurrency is set up in System Settings. If left blank, it defaults to no maximum.
  • Admin > System Settings > Anesthesia > MAXCONCURRENCIES - ANESTHESIA MAXIMUM CONCURRENCIES
    • If the Maximum Concurrency limit is reached, subsequent Claims enter a Finalization Hold (HFINAL) status.
  • ALL charges for the date of service MUST be entered.


Concurrency Workflow

  1. From Charges on the Left Side Menu, select the Anesthesia Concurrency button.

  1. Enter the DOS From and To that is ready for Concurrency processing.
  2. Services
  • All
  • Concurrencies Only
  • Valid Concurrencies Only
  • Invalid Concurrencies Only
  1. Select other Filter Criteria to narrow your search.
  2. Select Search.

  • Selecting All Services above displays all services for review/auditing.
  • All Invalid Concurrencies must be resolved before the process is finalized.

Services for Review/Auditing

  1. BillingBilling or Medically Directing Provider
  2. CRNA or AA (Anesthesia Assistant): The Rendering Provider
  3. Facility
  4. ConcurrenciesThe total number of Procedures occurring between the start and stop times.
  • Select the number link in the Concurrencies column to display all of the concurrent procedures under the thick black line.
  1. Billable: The number of Concurrencies that will be used to determine the correct Concurrency Modifier.
  2. Claim Split identifies how the claim will be generated
  • Line means 2 lines on a single claim (anesthesiologist and CRNA).
  • Claim means 2 separate claims.
  1. Modifiers: Identifies the Modifiers expected to be on the Encounter after the Concurrency is finalized.
  • An asterisk * identifies that the Encounter has not been finalized.
  1. DOS: Date of Service
  2. Start Time
  3. End Time
  4. Duration: Minutes
  5. Encounter Number: Use Ctrl plus left click on mouse to navigate to the Encounter on a new tab.
  6. Patient Number
  7. Patient Name


Pending Finalization

All Encounters with a Timed Procedure will be in a PFINAL (Pending Finalization) Encounter Status until they are finalized.

  1. Once Finalized, these Encounters will be in the status Ready for Submission.

The Finalize button becomes available when:

  • The Reference Batch where the Charge was entered is closed.
    • Before Charges are finalized, close the Reference Batches and attach to a new Reference Batch to run the Concurrency.
    • Any Encounters that are still in an open Batch will NOT finalize and will remain in a status of Pending Finalization.
  • All Invalid Concurrencies have been resolved.
    • This may require research, contact with the Provider, etc.
    • Reasons for an Invalid Concurrency:
      • A Provider has overlapping time on two Cases.
      • A Provider has exceeded the allowed Maximum Concurrencies.


The Claims will now be Ready for Submission.


Learn More

Anesthesia Time Unit Settings

Anesthesia Visit Concurrency

Anesthesia Medically Directed Modifiers

Anesthesia Charge Entry

Anesthesia Billing Resources

Anesthesia System Setting: Military Time


    • Related Articles

    • 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 ...
    • Anesthesia Time Unit Settings

      The Anesthesia Time Unit Settings determine how time is translated into Units. Set up a default that is used for all Payers. If a Payer uses a different (non-default) logic, add a separate Time Unit Calculation Profile and link to that specific Payer ...
    • Anesthesia Visit Coding

      Anesthesia Visit Coding is activated in System Settings > Charges > VISITCODING > Yes Users must be able to View Anesthesia Crosswalk to use Anesthesia Visit Coding. Admin > User Maintenance > User ID > Permissions > Admin > Setup > Time Unit ...
    • Anesthesia System Settings

      Activate Anesthesia A System Setting must be added to use Anesthesia Billing. Admin > System Settings > General > ANESTHESIA > Y Learn More: Anesthesia Billing Setup AFINALIZE -MAKES THE FINALIZE BUTTON VISIBLE This Setting prevents Anesthesia ...
    • Anesthesia Procedure Codes/Base Units/Concurrency

      The Base Units are set up in the Procedure Code Library in the Anesthesia Info Panel. Libraries > Procedure Codes button > Select the Procedure Code > Anesthesia Info Panel ***This panel is available only after Anesthesia Billing has been activated. ...