Wiki Anesthesia billing for a CRNA in an office based endoscopy center and an ACS

[baldi18]

Currently our company bills for the CRNA services without any problems. This company and the arrangement between the CRNA and the current physician performing procedures was initially set up through an outside company who did the credentialing, insurance contracts and billing initially. About a year ago we brought the billing in house. All has been going well. We are now bringing another physician in to perform procedures. This CRNA will provide the anesthesia services for this physician. We have been informed by a consultant that this new physician may have to be the supervising physician at the times he is performing his own procedures. She also stated that the insurance plans may need to have the physician added as a supervising physician in order for the company to bill and collect for the anesthesia services provided for this doctor.

Since our office was not involved in the initial set up we are not sure that the current physician was listed as a supervising physician for the CRNA with the insurance plans.

It is our assumption the supervising physician possibly needing to be added to insurance plans is not necessary. There is no area for the supervising physician on the HICFA. Does anyone have any information and/or knowledge in regards to this? Any help would be greatly appreciated. Thanks

 

[hgolfos]

The anesthesia modifier on the CRNA claim is what tells the insurance co that the CRNA was medically directed. QX is medically directed, QZ is without medical direction. The physician would file his/her own claim for the procedure with the correct modifier, QY is supervising one CRNA, QK is supervising 2-4 CRNA's concurrently and AA is anesthesiologist alone on the case.

Hope this helps.