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Here is an example,
If Dr. A would perform a three level discogram including documentation of intrepretation of images. The following would be billed for Dr. A services

62290 x 3
72295-26 x 3

If Dr. A ordered for the procedure to be performed under MAC. And a separate doctor, Dr C performed the anesthesia, The following would be billed for Dr. C services

01935 AA QS

Below is from the NCCI policy manual,

G. Anesthesia Service Included in the Surgical Procedure Under the CMS Anesthesia Rules, with limited exceptions, Medicare does not allow separate payment for anesthesia services performed by the physician who also furnishes the medical or surgical service. In this case, payment for the anesthesia service is included in the payment for the medical or surgical procedure. For example, separate payment is not allowed for the physician's performance of local, regional, or most other anesthesia including nerve blocks if the physician also performs the medical or surgical procedure. However, Medicare allows separate reporting for moderate conscious sedation services (CPT codes 99143-99145) when provided by same physician performing a medical or surgical procedure except for those procedures listed in Appendix G of the CPT Manual. CPT codes describing anesthesia services (00100-01999) or services that are bundled into anesthesia should not be reported in addition to the surgical or medical procedure requiring the anesthesia services if performed by the same physician.
 
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