Anesthesia Coding Alert

Question: Our anesthesiologists would like the groups certified registered nurse anesthetist (CRNAs) to follow up on postoperative pain control, including patient-controlled analgesia (PCA). They would like to bill 99231 (Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least two of these three key components: a problem focused interval history, a problem focused examination, medical decision making that is straightforward or of low complexity) for this under the physicians name as incident to. What advice can you offer?

Colorado Subscriber
 
Answer: Incident to is only relevant in an office setting. If nonanesthesia-type services (such as preoperative line placements or pain follow-up visits) occur in a hospital setting, physician assistants and CRNAs employed by the group can be credentialed by Medicare and bill under their own names. For non-Medicare carriers, ask how they want this scenario billed and get a copy of their policy in writing.