Anesthesia Coding Alert

Question: My anesthesiologist has been asked to perform anesthesia in an office surgical suite which would be billed as POS 11 (Office). Do Medicare and other payers allow and reimburse for anesthesia administration codes to be billed in POS 11?

Idaho Subscriber

Answer: Anesthesiologists work in and bill for services POS 11 all the time. The anesthesia group would definitely perform Medicare cases, and commercial cases as long as they were participating with the insurance. I think the only issue would be insurance participation. If you’re not participating and the plan doesn’t have out-of-network benefits, you won’t get reimbursed. If you’re not participating and the plan does have out of network benefits, your reimbursement will be subject to the out of network patient responsibility (deductible and co-insurance).

In general: Yes, you may bill anesthesia services in the office. However, there may be strict coverage requirements to take into consideration, such as during screening colonoscopies or interventional pain management procedures for adults.