Anesthesia Coding Alert

Question: We bill for the service of the CRNAs who work in our clinic. How should we bill out the services being provided by a new CRNA that we're in the process of getting Medicare's enrollment approval for? She normally does not have medical direction during the procedures. Do we hold the claims until all the paperwork is approved then send out the claims to insurance companies? Or handle it like a locum tenens?

Delaware Subscriber

Answer: According to the Centers for Medicare and Medicaid Services (CMS), a provider who enrolls or re-enrolls with Medicare may only bill for services provided up to 30 days prior to the "effective date" of the application. The "effective date" of the application is the later of the date you filed a Medicare enrollment application that was subsequently approved by a Medicare carrier or the date you, as an enrolled provider, first begin providing services at a new practice location. This rule applies to physicians, non-physician practitioners, and physician and nonphysician practitioner groups.

Remember: Locum tenens modifiers are reported for physician services and do not apply to your CRNAs. Best practice is to have providers numbers in place before the CRNA begins working with your clinic.