Anesthesia is a medication administered by professionals for procedures that are significantly painful for patients that either numb them or put them in a deep sleep. There are two main types of anesthetics, local and general. Local anesthesia works on the skin where it’s been injected; this is often used for biopsies or dental work, while the patient is awake. General anesthesia is used mainly for surgeries and procedures that patients cannot bear the pain of.

If your medical institute administers anesthesia to the patients who need it, here’s all you need to know about its billing procedures:

Know your modifiers

To correctly bill a patient’s insurance payer, you need to be aware of the modifiers when it comes to anesthesia medical billing. These modifiers are required for reimbursement. Your practice can be negatively affected by incorrect billing. Here are the modifiers to know about:

• AA: this code is used when an anesthesiologist delivers services personally.
• AD: is used when anesthesia is administered by a physician for a procedure.
• QK: a practitioner supervises two simultaneous procedures that require anesthesia.
• QX: CRNA/AA services with or without an anesthesiologist.

Ambiguity or lack of knowledge on modifiers can result in delayed or denied claims by insurance providers. It’s essential that those in charge of anesthesia billing know what they are referring to.

Carefully calculate time unites

The anesthesia billing cannot go forward unless the method of calculating the time units of each procedure is determined. This aspect of medical billing faces the most errors.

For procedures that require anesthetics, an individual must calculate the total time from when the anesthesiologist is present with the patient. To correctly calculate this, various formulas are used, which require base units and time units as well as a physical status modifier.

Every segment is taken to be 15 minutes, segments of over 7 minutes are rounded up, e.g. if a procedure is 70 minutes long, it consists of 5 segments, not 4.

Stay up to speed changes in the industry

Medical billing for anesthesia is vastly different to other procedures, though it may seem to be. The common misconception is that the billing process and details of billing will be similar to that of a surgery or family practice. Lacking the knowledge on industry norms will negatively affect your practice.

Anesthesia billing also differs across the states in America. What’s applicable in one state doesn’t necessarily apply to another. Always make sure you’re following state rules and are updated on any state-wise change in medical billing.

If your medical practice requires help with medical billing, employ the services of A & B Medical Billing Solutions. We provide medical billing services to clients in Delray Beach.

Call us at 954-596-9966 to learn more about our services.