# Billing an anesthesia consult



## Girlzsmom66 (Jul 25, 2017)

I have recently had some discussion with our office administrator as to why we are not billing anesthesia consults for our CRNA.  Also, does any ASC EVER include (build in) an anesthesia charge with their surgeries?  To me, this is strange.  If others know of this happening (as in a surgical package), would you please enlighten me?  

I would use an E/M code for the consult with a pre procedural icd 10.  Would this be appropriate?

Also, if the CRNA is doing a stellar job documenting start/stop times, why would any ASC want to "build in" the anesthesia?

Thank you so much for your assistance coding friends!


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## thomas7331 (Jul 25, 2017)

A E/M code would not be appropriate for evaluation of the patient prior to anesthesia - per both CPT and CMS/NCCI guidelines, the codes for anesthesia service already include pre- and post-anesthesia care by the provider.  Also, evaluation of a patient prior to anesthesia does not meet the definition of a consult which is basically another provider's request for a specialist's opinion about how to treat a patient's particular problem.  A CRNA can provide and bill a consult if they are requested to perform one, but not just for their routine pre-procedural work.  

As far as your question about 'building in', I'm not completely clear what you mean.  ASC billing includes only facility charges, not professional, so the facility's costs for the anesthesia would in fact be inclusive to the ASC's surgical procedure's case rate, but the professional charges would not be - these are two different things.


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## Girlzsmom66 (Jul 25, 2017)

*thank you*

I appreciate the confirmation on the CRNA and pre op consult.  I did know that...just helps to be reminded, so thank you!

Our ASC is not billing anesthesia.  Our CRNA is documenting the start/stop times, but we are not billing their service.  I understand the anesthesia is included in the surgical package, we are simply not billing the CRNA time.  Also, which modifier would be appropriate for the CRNA service being supervised by the MD, in an ASC setting.  QZ?

Thank you so much!  I honestly appreciate the feedback and the learning from questions I ask!


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