Anesthesia Coding Alert

Question: My anesthesiologist has been asked to perform anesthesia in an office surgical suite that would be billed as place of service (POS) 11 (office). Do Medicare and other payers allow anesthesia administration codes to be billed in POS 11 and cover them in that POS?

Arkansas Subscriber

Answer: Anesthesiologists often work in settings that qualify as POS 11 and bill for their services without problems (for example, delivery suites are POS 11). The anesthesia group should also not have trouble billing for Medicare or commercial cases as long as the providers participate with the insurance.

Caveat: Be aware that there might be strict coverage requirements for services in these settings, such as interventional pain management procedures for adults. You could also run into reimbursement issues if your group doesn’t participate with the insurer. If the plan doesn’t have out-of-network benefits, the anesthesiologist would not be paid. If the plan does have out of network benefits, reimbursement will be subject to the out-of-network patient responsibility (deductible and co-insurance).