Anesthesia Coding Alert

Question: Our time unit for anesthesia services in California is 15 minutes. Our computer would charge three time units for 45 minutes but would charge four units starting with the 46th minute. How should we charge for the minutes that follow a complete time unit? Our computer would have to be reprogrammed if this is not in compliance.

California Subscriber

Answer: The way your computer responds to time is common. With all non-Medicare patients, we round up to the nearest whole unit value. Therefore, we would charge four units of time for all procedures lasting 46-60 minutes. With Medicare patients, we charge by the 10th of a unit. Our computer does the following minute/unit computation: 1=0.1, 2=0.1, 3=0.2, 4=0.3, 5=0.3, 6=0.4, 7=0.5, 8=0.5, 9=0.6, 10=0.7, 11=0.7, 12=0.8, 13=0.9, 14=0.9, 15=1.0. Our system will not use fractions, but if you are reprogramming and can use fractions, then 1/15, 2/15, etc., would be even more accurate.

We think that billing to the nearest 10th of a unit meets our carriers requirement as well as most other Medicare carriers. If you are considering going to the expense of reprogramming, it is advisable to check your local Medicare carriers procedures. (For example, research if 10ths of units are accurate enough, or if they prefer 100ths.) Also, be sure that your new program continues to round up to the nearest whole time unit for non-Medicare patients.