Anesthesia procedure codes begin with zero when the service is rendered by anaesthesiologists or Certified Registered Nurse Anesthetist (CRNA). Legion Healthcare Solutions (LHS) understands different modifiers used for anesthesia specialists, anesthetists or CRNAs. Based on the regulations of CMS anesthesia allowable charge will be determined based on the anesthesia conversion factor and modifier submitted claim. Anesthesia Medical billing can be complicated when a group of anesthesiologists and CRNA are working together is the case when line items can be multiple for each of the portions performed.

LHS understands the requirements of multiple providers involved for anesthesia procedures and each line item will be indicating the provider performed the service. Performing the anesthesia billing, LHS billers and coders understand the inherent requirement of various modifiers and the need of documentation to develop the payment posting.

“Patients are usually at different stages when it comes to need for anesthesia procedure, this requires the procedure performing anesthesiologists or physician or team to document the complete condition. While the time units can vary greatly based on the patients and it’s a condition, procedure documentation is the most important step.”

– a Medical Biller at LHS.

LHS has observed that most anesthesia billing denials or part payments are due to errors in time units. While 15 minutes is equal to one-time unit and most of these units are rounded to a tenth. The time for anesthesia begins when you start preparing the patient for induction and ends when the patient is placed under postoperative supervision.

In case when an anesthesiologist is providing the direction to CRNA, both should bill for the appropriate component of the procedure performed. LHS medical coders will be using appropriate anesthesia modifiers for the claim.

Certified coders use current procedural terminology anesthesia a five-digit procedure code developed American Society of Anesthesiologists (ASA) or procedure surgical codes.

Pre-operation review of a patient is imperative, before administering anesthesia the patient needs to be monitored for substance dependencies that might affect his condition during operation.

Claims for anesthesia billing are matched with patients' procedures in the hospital. LHS understands the requirement of both hospital and anesthesiologist hence an impeccable document and claim are prepared for maximum account receivable.

A documentation expert will share a format of all the documents required before the anesthesia procedure.

Prior authorization in case of non-emergency service to improve the account receivable.

In case of co-payment, the patient and anesthesiologists will need to discuss the setting for payment.

Legion medical billers constantly monitor the claim process at the payer side to keep AR days as low as possible.

API-and RPM-based technology to improve the patient experience.