Medical Billing for Anesthesiology

Anesthesiology Medical Billing

Anesthesia medical billingAnesthesiology procedures and practices are very susceptible to audits due to its complex billing practices. The coding, billing, and time factors are often times the main concerns for Medicare audits, potentially resulting in the aggressive government investigation and clampdown on funds allegedly used inappropriately.

For over two decades, the experts at MPMR have been working with anesthesiologists in small or large groups. MPMR provides certified coders and medical billing specialists who are experienced in anesthesiology billing with all the nuances it entails.

Common Anesthesiology Billing Issues

Anesthesiology is not exempted from the watchful eye of medical auditors. Multiple recurring issues have been cited by several medical auditors citing the most common problem areas for anesthesiology billing procedures. Anesthesiology billing suffers the same billing problems that other medical billing procedures have. Improper billing procedures are either influenced by perspective, neglect, and at some cases, fraud.

Medical billing is incorrectly regarded as a subjective form of billing, where medical professionals can charge depending on the procedures performed, the instruments and equipment used, and the approximate length of time spent with the patient. Anesthesiology billing is an objective procedure that has a set of guidelines to close the margin for error at a minimum.

Factors to Consider with Medical Billing in Anesthesia Practice

  • Time factorThe time factor in anesthesiology is no different from other practices. Billing procedures are mainly concerned about valid billable hours, from start time to end, and Medical billing for anesthesiologyrounding-off time. Since medical practitioners are paid a significant hourly rate, even rounding off time is a major concern. Anesthesiology practitioners must make their billable time claim valid by providing monitoring to support the billable time submitted.
  • Bill time – A common problem with anesthesiology billing is the common practice of anesthesia practitioners to bill time prior to the in-room time, and billing time after the out of room time. According to Medicare, the accurate definition of anesthesia time is the period during which the practitioner (the physician, AA, or CRNA) is present with the patient, and it ends when the practitioner is no longer providing anesthesia services to the patient, such as when the patient can be safely transferred over to post-operative care.
  • Coding – It’s imperative that anesthesiologists maintain a good communication with the billing staff to ensure an accurate and well-documented billing. Inadequate documentation may lead to auditors to suspect incorrectly billed procedures. Consistency in coding is also crucial to avoid being tagged as false claims. Proper coding and tagging of procedures will provide adequate support to the billing claim. To exercise proper coding on anesthesiology billing procedures, it’s important to provide adequate documentation for the following: spinal procedures, approach, technique, position, and site.
  • Base units – Each anesthesia Current Procedural Terminology (CPT) code has its own value assigned depending on the complexity of the procedure performed. Medicare considers base units as the most important parts of the anesthesia service, and therefore, are included in the procedures. ASA updates and assigns base units annually, and invasive Anesthesiology medical billingmonitoring devices are not considered as a part of the base units. Rather, base units are billed separately.
  • Special Units – These are additional units that can only be added if specific conditions are met. These special conditions affect the overall billing units. Anesthesiologists earn special units when the patient’s anesthesia procedure is complicated by extreme age, total body hypothermia, controlled hypotension, and emergency conditions.

Other Factors to Consider

Consultations for patients due for an operation are considered as a part of the anesthesia procedure as a whole, and they are not separately billable. Consultations for post-operative pain management, however, are an entirely different case and they may allow for these services. Anesthesiology procedures are considered personally performed if the anesthesiologist is constantly involved in the progress of a single case.Medical Billing Neurology

When billing for a personally performed procedure, the physician may not leave the premises of the operating room to perform medical services on a different patient. If the anesthesiologist is not consistently involved with the case, then the procedure cannot be billed as a personally performed procedure. These are the basic guidelines for medical billing related to anesthesiology.

MPMR has been working with anesthesia medical billing for many years. Typically, MPMR is able to increase revenue significantly, and also provides contracting and credentialing services as well!

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