# Anesthesiologist and CRNA Billed at the same time???



## thomson_theresa@yahoo.com (Sep 23, 2011)

Have a provider billing for 01992-QY and 01992-QX for a diagnostic spinal injection. Neither is performing the actual injection. The documentation supports conscious sedation. Are they both entitled to bill 01992? And I am also seeing where there is a 5 base units and we would never bill over 30 mins if I had a patient under for 6 mins would that be 1 unit? So when billing would I put in 6 units and then TOS 7 and Minutes 6?


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## lovetocode (Sep 23, 2011)

Yes, you can bill for 01992 for both dr and CRNA with appropriate modifiers.  01992 carries a base of 5 plus the 1 unit for time, so total time units would be 6 and the type of service is 7.  Also, anes code 01991 states anesthesia for diagnostic or therapeutic nerve blocks and injections *when block or injection is performed by a different provider.*


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## thomson_theresa@yahoo.com (Sep 23, 2011)

*01991 or 01992*

So if all of our patients are in the prone position we would only use the 01992 correct?


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## thomson_theresa@yahoo.com (Sep 23, 2011)

*Also*

Do I put them on two seperate claims or bill on one?

01992 QX and 01992 QY?


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## lovetocode (Sep 23, 2011)

Yes, your codes and modifiers are correct and can be placed on one claim.  We submit all our claims this way.  Most insurances accept one claim for both charges, however, special commerical insurances may break down into 2 claims themselves and pay separately.


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## thomson_theresa@yahoo.com (Sep 23, 2011)

Thank you soo much for your help!!!!


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## dwaldman (Sep 26, 2011)

The way I am billing Anesthesiologist and CRNA involved in one case is on two separate claims when using QY and QX. I place the total minutes of the case in the units field on the CMS-1500 and QS modifier as needed. This way they pay one claim under the anesthesiologist NPI at 50 percent and the other claim is submitted under the CRNA's NPI which will be paid at 50 percent to add up as 100 percent of the allowable as if it was billed as AA or QZ as a single claim. This is from a Medicare concept of billing, but I don't hear about too many problems from the private payers.


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## dwaldman (Sep 26, 2011)

I reread the initial question that states conscious sedation---I was referring to general or MAC in my previous post. If it was indicated that it was conscious sedation I would use the appropriate codes for this service.


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