Don’t Bill for PCA as Anesthesia Service
Question: A patient was receiving remifentanil as patient-controlled analgesia (PCA) for pain control while in labor. The patient ended up needing a cesarean section, for which other anesthesia services were provided. Can I bill for the PCA? Massachusetts Subscriber Answer: You can bill 01961 (Anesthesia for cesarean delivery only) for the anesthesia provided during the C-section, but you cannot bill separately for the PCA as an anesthesia service. PCA is an intravenous (IV) medication that can be ordered by a physician, since ordering treatments are part and parcel of a physician’s care. The way that PCA is administered also underscores why the provision of such services cannot be billed separately to a physician. When PCA is ordered, the medication is presented in a cartridge, which a nurse can insert into the IV pump and program accordingly. Since this process does not require the physical presence of a physician, and no anesthesia service is provided, you cannot bill PCA on behalf of the anesthesiologist. Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC
