Anesthesia Coding Alert

Check local ACF to see what you'll really submit

Congress froze the expected 5 percent payment cut for 2007, but that doesn't mean all of your payments will remain the same -- especially since anesthesia reimbursement varies from state to state, or even within regions of the same state.

The numbers: To keep the reimbursement rate the same, Congress approved a freeze that if passed will keep the conversion factor (CF) at the current 2006 rate of 37.8975 instead of decreasing it to the scheduled 2007 rate of 35.9848.
 
Anesthesia fluctuations: The CF you'll report for anesthesia services (ACF) depends on your geographic location, as usual. The 2007 ACFs range from $14.92 in Oklahoma and $14.93 in South Dakota to $19.38 in the Detroit area. Log on to the American Society of Anesthesiologists' Web site (www.asahq.org) to see a complete list of this year's ACFs. 

The original plan: To increase values for cognitive services like 99213 and 99214 (Office or other outpatient visit for the evaluation and management of an established patient ...) while maintaining the mandated budget neutrality, CMS had planned on cutting the CF across the board. 

"There was an outcry from numerous physicians and physician associations to the planned 5 percent cut to the conversion factor," says Russ Still, executive vice president of Medical Management Associates in Atlanta.

You'll Really See About 2 Percent More 

A freeze, however, does not mean code payments will remain the same in 2007. Because of the five-year review, the CF only tells part of the reimbursement story, Still says. To calculate a code's payment, you also need to look at any changes to the code's work and practice expense (PE) relative value units (RVUs).

Example: If the scheduled 2007 CF cut takes effect, your reimbursement for 99213 for a pain 

Get updates: Go online to the Federal Register or the ASA's Web site (www.asahq.org) for updated information and how it will affect your practice.