# how to bill anesth for a CRNA under contract



## hudsondna (Jun 13, 2008)

Howdy All,
I need some help. I code for a pain management group (2 doctors). When we bill a procudure ie: nerve block one doctor does the nerve block and the other does the anesthesia (not concious sedation). Here is my question... One of the doctors has gone on vacation and the other doctor has contracted a CNRA to help administer the anesthesia. The performing provider has paid the CNRA for her services therefore will not be billing her services to the insurance. How do I get the anesthesia services paid? Would I use the 47 modifier and is this something Medicare will pay for? 
Thank you,
Anita Hudson, CPC
979-204-1584


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## AYCPC (Jun 20, 2008)

*Re: Anes For A Crna Under Contract*

You Would Bill The Crna Service As A Locum. However Our Anesthesia Practice Is Getting Denial From Medicare For Our Crna Locum Coverage. You May Want To Check The Cms Website, But I Do Not Think They Will Pay.


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## Codingabc123 (Jul 1, 2008)

From the 2/2008 version of the TrailBlazer FI anesthesia manual:
"Locum Tenens
Locum Tenens does not pertain to a CRNA. CRNAs are required to have a Medicare number in any locality where they perform services."

Since your physician has contracted and paid to have the CRNA provide services, that CRNA is a contractor whose services should be billable by the practice.  It would require the CRNA to be credentialed under the group for billing Medicare.  Under the circumstances you describe, the CRNA would be billed as working without medical direction or supervision while providing anesthesia for the pain service.  The QZ modifier should be appropriate.

As always, check with the payer to find out how they want the services reported.

Hope this helps and is not too late.  My first foray into the forums!


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