Anesthesia Coding Alert

Plus: National Medicare CF could drop 27 percent.

Get ready to end another year wondering how much your Medicare payments will be reduced in 2012. According to the Physician 2012 Medicare fee schedule Final Rule printed in the Federal Register on Nov. 1, the 2012 national anesthesia conversion factor (ACF) will be $15.5264 unless Congress acts to avoid the cut.

An ACF of $15.5264 represents a 26.2 percent decrease from the national ACF in 2011, due to other factors impacting the CF.

Remember: Although the national ACF might be $15.5264, you won't automatically use that number when calculating your claim fees. Instead, you'll use the specific ACF that applies to your geographic area, which takes local economic and practice expense factors into account.

Example: The national ACF for 2011 is $21.05, but the local ACF for Delaware is $20.75. If you code for physicians in Delaware, you should use $20.75 in your fee calculations instead of the national ACF of $21.05.

Watch for Cuts to Non-Anesthesia Services

If your anesthesiologist offers surgical-type services (such as pain management injections), you also rely on the national conversion factor for fee calculations.

According to the Nov. 1 Final Rule, "the calendar year 2012 Physician Fee Schedule conversion factor is $26.6712." The proposed amount represents a 27.4 percent cut compared to the current conversion factor of $33.9764.

Responses: Physician advocacy groups were quick to express their opinions of the cuts. "Payments for Medicare physician services have fallen so far below increases in medical practice costs that there is a 20 percent gap between Medicare payment updates and the cost of caring for seniors," said AMA president Peter W. Carmel, MD, in a Nov. 1 statement.

Bright side: "President Barrack Obama and Congressional leadership have all expressed strong support for averting the scheduled 27.4 percent DGR [sustainable growth rate] cut set to go into effect Jan. 1, 2012," states a news piece on the American Society of Anesthesiologists' website.