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Medicare Compliance & Reimbursement

Reader Question:

Know CRNA Choices for Colonoscopy

Published on Thu Jun 28, 2012

Question: Is a certified registered nurse anesthetist (CRNA) allowed to bill Medicare for anesthesia during a colonoscopy? Are there certain requirements?Answer: Yes, a CRNA can bill Medicare for colonoscopy, although several carriers do not recognize anesthesia as medically necessary for endoscopies. If you file a claim, the correct code depends on the type of sedation administered.For general anesthesia or monitored anesthesia care (MAC), report 00810 (Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum). Reporting MAC is appropriate if the carrier recognizes that anesthesia service is medically necessary for the procedure or if you plan to bill the patient. If the payer requires MAC modifiers, append as applicable: QS (Monitored anesthesia care service), G8 (Monitored anesthesia care [MAC] for deep complex, complicated, or markedly invasive surgical procedure) or G9 (Monitored anesthesia care for patient who has history of severe cardiopulmonary condition).›› For moderate sedation, choose from 99148 (Moderate [...]
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