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Best Practices Of Anesthesia Medical Billing

Anesthesiologists are truly the unsung heroes of surgical procedures. They provide appropriate dosages of medicine so that a patient feels no pain during surgery. They are also responsible for reducing the dosage to bring the patient out of sedation after the procedure. During the pre-surgical phase, they determine the medicines depending on the patient’s medical history. While during the surgical procedure, they monitor the patient and modify the dosage accordingly.

Owing to the intricate work of an anesthesiologist, it is important that their services are billed and reimbursed accurately. By implementing a robust approach to anesthesia medical billing, healthcare facilities can strengthen their revenue cycle management.

Through this article, let us discuss the best practices of anesthesia medical billing that will systematize your anesthesiology practice.

Using Accurate Anesthesia Codes

When filing medical claims, the staff at your anesthesia practice should be aware of accurate anesthesia billing codes. Your staff should be up to speed with codes such as AA, which is used for any anesthesia service offered by an anesthesiologist, and AD, which is a code for anesthesia treatment provided under a physician’s supervision. Submitting claims with incorrect anesthesia codes results in increased claim denials. To mitigate that, your staff must ensure the use of accurate codes for each service rendered.

Adequate Documentation

To file accurate anesthesia medical claims, healthcare facilities must keep a detailed record of the anesthesia services rendered. According to the American Society of Anesthesiologists and Medicare, there are seven elements that must be documented in an anesthesiology medical claim. These elements are

  • Performing a pre-anesthetic examination and evaluation
  • Prescribing an anesthesia plan
  • Participation in demanding procedures, including induction and emergence
  • Any procedures in the plan that the anesthesiologist does not personally perform must be carried out by a qualified individual.
  • The course of anesthesia administration should be monitored at frequent intervals.
  • Remain physically present for all key and critical portions of the procedure and be available for immediate diagnosis and treatment of emergencies.
  • Providing post-anesthesia care as indicated.

Accurate Reporting Of Time

Calculating time and base units is a crucial part of anesthesia medical billing. Base units are quantitative values assigned by the Centers for Medicare & Medicaid Services (CMS) to anesthesia CPT codes. The total time (in minutes) spent on completing a medical procedure is used to calculate time units accurately. To bill anesthesia services with precision, a time unit equals fifteen minutes. Precise anesthesia medical billing requires accurate documentation of the beginning and ending times of a surgical procedure.

When a patient is prepared for anesthesia services in the operating room, the time documentation begins. It ends when the surgeon’s constant attendance is not required, and the patient can be safely placed under postoperative care.

Billing And Coding Challenges

In anesthesia medical billing, it is important to determine CPT codes for the procedure that was performed. All anesthesia medical billing claims should clearly communicate the name of the service/procedure and its reason. HIPAA regulations require all anesthesia facilities to use specially designated codes to claim services. Medical billing and coding specialists are up to date with CPT anesthesia codes applied for a range of diagnostic or therapeutic services (e.g., 00790) and limited or specific needs (e.g., 01402).

The Healthcare Common Procedure Coding System (HCPCS) includes codes and modifiers specific to anesthesia care. These codes help in submitting claims to Medicare and other insurance payers accurately.

The billing staff should be aware of modifiers used in anesthesia medical billing and coding, such as AD (medical supervision by a physician for more than four concurrent anesthesia procedures). A QZ modifier is used in the case of a CRNA without medical direction from a physician.

The billing staff at your healthcare facility should understand how these codes are intended to be used so that all medical claims are accurate. This will be helpful in avoiding fraudulent billing, resulting in prompt and accurate payments for the care provided by anesthesiologists at the facility.

Outsourcing Anesthesia Medical Billing

To minimize denial rates and ensure maximum revenue collection, it would be judicious for your anesthesia practice to outsource its medical billing to experts. This will ensure quality billing and faster payments. You will get a guaranteed return on your investment. The end-to-end billing service from experienced medical coders and billers will ensure that you get the last dollar for the services rendered.

Partner With Eminence Healthcare Services

Eminence Healthcare Services is a premium medical billing company that offers comprehensive revenue cycle management services to its clients across the USA. Anesthesia medical billing is one of the top specialties handled by Eminence RCM. Benefit from the team’s expertise in navigating complex regulations and policies, ensuring compliance, and ensuring accurate billing. Our efficient team will streamline your billing process, reduce errors and delays, through advanced technology, such as electronic billing and claims management software.

With our expertise, anesthesia practitioners will be able to identify areas for improvement and optimize their revenue cycle management process. On top of that, with our transparent billing practices, anesthesia practitioners and healthcare facilities can increase patient satisfaction and retention. With efficient anesthesia billing services from Eminence Healthcare Services, healthcare providers can provide excellent care to their patients and ensure the smooth functioning of their financial systems.

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