# Anesthesia/CRNA Billing Question



## mthompson01 (Dec 18, 2008)

Per Medicare guidelines...when physician is over more than four concurrent cases at a time the  modifier then changes to AD and they are to only bill 3 base units.  Do you know if this means 3 base units plus time units or strictly 3 base units with no time units?  Also, is this what we are required to bill out or does it mean this is all that we will be reimbursed?

Thanks,
Melody Thompson, CPC
mxsubotn@sentara.com


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## matkins (Dec 18, 2008)

Accordng to the Medicare policy manual, it reads 

"Carriers may allow only three base units per procedure when the anesthesiologist is involved in furnishing more than four procedures concurrently or is performing other services while directing the concurrent procedures. *An additional time unit may be recognized if the physician can document he or she was present at induction."*

According to this, you are only getting paid for 3 base units per procedure, unless your physician is present at induction and it has to be documented as such, to get one additional unit. 

Hope this helps!


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