Anesthesia Billing & Coding Services
Anesthesiology deals with the total perioperative care of patients before, during, and after surgery. The specialty’s core element is the use of anesthesia and anesthetics to support the vital functions through the perioperative period safely.
An anesthesiologist administers the right dosage of drugs to the patient so that’s he/she does not feel any pain or regain consciousness during surgery. They are also responsible for waking the patient post-surgery. They monitor the patient’s vitals keenly during surgery and alter the dosage administered accordingly.
There are different levels of Anesthesia providers – the Anesthesiologists, Certified Registered Nurse Anesthetists (CRNA), and Anesthesiologist Assistants (AA). They take on a critical role in understanding the patient’s history & conditions. But unfortunately, they are justified that they get billed correctly for their services and get reimbursement to the maximum.
Components of Anesthesia Billing
Anesthesia billing can become complicated as it requires documentation of a high number of records, such as:
- Pre-operative Review. The pre-operative review consists of the patient’s and their family’s medical history, drug, or tobacco habits that have to be taken into account while calculating the required dosage of anesthetics.
- Anesthesia Sheet. The Anesthesia sheet involves the documentation of the following:
- Base Units: The base units reflect the complexity and the skills required for the anesthetic service provided. The CMS publishes the base units once every year.
- Time Units: This is the time spent with the patient administering the anesthetic or monitoring the patient’s condition before, after, or during the surgery. Time units are calculated by dividing the total minutes of service by 15
- Modifiers: Anesthesia “provision/supervision” modifiers (-AA, -QK, -QY, -QZ, and -QX) explain the role of the anesthesiologist and CRNA. These modifiers are essential for clarifying whether an anesthesia procedure was personally performed, medically directed, or medically supervised by an anesthesiologist.
- Formula: (Base Units + Time Units + Modifiers) x Conversion Factor = Anesthesia Reimbursement
- Bundled services: Do not bill the following procedures along with anesthesia procedures.
- Do not bill for the Injection of diagnostic or therapeutic substances along with anesthesia procedures (62320 – 62321 and 62324 – 62325)
- Nerve Blocks (64400 – 64530)
- Transesophageal Echo (TEE) (93312 – 93318)
- Laryngoscopy (31505, 31515, 31527)
- Bronchoscopy (31622, 31645, 31646)
- Post-operative Review. The post-operative review consists of records that state that the patient has not suffered any complications due to the anesthetic administered.
Success of Anesthesiology Service
The success of an anesthesiology service largely depends on its ability to generate & collect revenue. The ingredients for successful anesthesia billing include an experienced and trained revenue cycle team, specialty-specific billing software, and compliant billing practices. Outsourcing your billing & coding needs will help shift your focus to offering improved patient care. Medical Billing Wholesalers consists of a team of experts who receive specialized training in billing for anesthesiology services.
Medical Billing & Coding Services Expertise in Anesthesia
At MBW, we have a client base that extends over 50 states covering a wide range of hospitals, physician practices, and medical billing companies. Our coders are proficient in ICD-9/10, CPT, HCPCS codes based on CMS and AMA guidelines and certified by the American Academy of Professional Coders (AAPC). It would be fair to state that we have a decade of experience in pediatric billing & coding.
Applying best practices for Anesthesia Billing & Coding Services
By obtaining authorization and validating the patient’s eligibility and benefits before the surgery. We are also aware of the services that can or cannot be bundled together with the anesthesiology service offered. In case of the absence of a valid medical reason for the necessity of a drug administered, we follow-up with the physician, clarify the medical necessity for the procedure, and state it clearly to claim rejection. Our expertise in Anesthesiology billing & coding includes but is not limited to:
- Topical infiltration
- Local anesthesia
- Metacarpal/Metatarsal/Digital blocks
- Regional anesthesia o Peripheral Nerve Blocks o Epidural or Spinal Anesthesia
- Monitored Anesthesia Care
We bring nothing less than excellence, knowledge, and accuracy while building a revenue cycle devoid of defects for your practice. Our team strives to introduce a friction-free billing, coding, claim submission, and payment posting process. To help achieve maximum reimbursements, we ensure that.
- Consistent accounts receivable follow-up is performed.
- Prior authorization is performed regularly.
- The anesthesiologist is credentialed and eligible to be reimbursed in a regular man.
- Our denials team focuses on shifting your focus from denial management to denial prevention.
Medical Billing Wholesalers help the unsung heroes – Anesthesiologists to focus on offering excellent care for their patients, as we focus on improving their administrative & financial excellence. We bring you a team of specialists that are:
- Certified by The American Association of Professional Coders (AAPC) and has received training in most common Medical Coding Software
- Successful in processing medical claims with most common commercial insurance companies including UHC, WellPoint, Aetna, Humana BCBS, and Anthem, and government payers such as Medicare
- Successful in working with Medicare and understand state-specific Medicaid Policies
- Experts in reducing costs and helping you achieve improved clinical and operational efficiency