Anesthesia Coding Alert

Following guidelines for reporting CRNA (certified registered nurse anesthetist) services isn't impossible once you correlate her care with the service your anesthesiologist provides.

If CRNA coding throws you for a loop, check out these four scenarios straight from some of our readers.

Scenario 1: The anesthesiologist started a case at 6:52 a.m. The CRNA came in about 30 minutes later (at 7:25 a.m.) and finished the case with the physician. The case ended at 8:07 a.m. The CRNA was not present during the entire case. How do you report split billing?

Scenario 2: You're coding for a medically directed case involving two CRNAs. The first CRNA began the case. A second CRNA relieved the first and finished the case. They did not spend equal time on the procedure; how should you report each CRNA's service?

Scenario 3: Anesthesiologist A medically directed a CRNA during a case's first portion. Anesthesiologist B arrived and relieved Anesthesiologist A. The CRNA also left, leaving Anesthesiologist B alone for the rest of the case. How do you correctly report the direction?

Scenario 4: Your physician performs a pain management procedure while a CRNA administers the anesthesia (moderate sedation). How do you code the CRNA's role in the case? Once you've had a chance to decide how to handle each situation, turn to page 100 to see how your coding compares to our experts' advice.