# Anesthesia Help needed



## clgregory (Apr 22, 2009)

I need to know where to find information on the ability to have two anesthesiologists or two CRNA's bill for the same service on the same patient.  This is usually only for a portion of the time and in very urgent situations.  I have found where MCR talks about a CRNA and anesthesiologist can bill AA for the same patient but no where for two CRNA's or two anesthesilogists.  I can assume that you would have to document the time and why but do not want to just assume.  Thank you.


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## FTessaBartels (Apr 22, 2009)

*Wrong forum*

You might want to post your question under the MEDICAL CODING /Anesthesia forum  (This is posted under LOCAL CHAPTERS / General Discussion).

F Tessa Bartels, CPC, CEMC


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## jdrueppel (Apr 22, 2009)

The answer to your question: Can two anesthesia providers be involved in the same case at the same time?  is in the CMS Manual Chapter 12 Sections 50 (MDA billing guidelines) and 140 (CRNA billing guidelines).  Both providers will need to document medical necessity and time.  This scenario is also minimally addressed in the ASA Relative Value Guide.  A separate anesthesia record by the second provider would be the best documentation but I have not been able to convince my providers of this so my documentation is usually within the single anesthesia record and progress notes.  

When we have a Medicare two provider case we submit the primary anesthesia provider's service and wait for that to be paid.  Once paid we then submit the second anesthesia provider's claim noting documentation available.  Otherwise Medicare was simply paying the lower of the two charges and then deny the other with the B20 denial code (Benefits were partially or fully paid to another provider) or duplicate.  

As far as all other payers, we get paid by nearly all when medical documentation supports the charge by a second anesthesia provider.

Hope this helps.
Julie, CPC


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## clgregory (Apr 23, 2009)

*anesthesia*

Thank you - that is what I figured would have to happen but was just not able to find the documentation.


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