Wiki anesthesia billing help

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jgray2006

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I have two questions

1. how would you bill for anesthesiologist who is present during an entire office based surgery monitoring vitals but never administers any drugs? Would we still bill mac?

2. how would you bill for an anesthesiologist who is on stand-by in the hospital. Basically surgeon will not perform surgery unless anesthesiologist is present.

Any help is greatly appreciated
 
I just cut and pasted this from an 8/20/13 post

Several payers have documented definitions of "stand-by" anesthesia. The following is the definition provided by Anthem:
Standby anesthesia service is when the anesthesiologist would be immediately available if a clinical need should arise but the anesthesiologist may be elsewhere performing other duties. Stand-by anesthesia is considered medically necessary when a procedure, which does not normally require anesthesia services, has a significant potential for catastrophic complications or potential for the need of other intervention that would require immediate availability of general anesthesia.

Medicare does no pay for "stand-by" anesthesia:
http://www.medicarenhic.com/provider...llingGuide.pdf See page 12

Medicare and the ASA also have very clearly defined MAC anesthesia and the requirements necessary to bill for it.
This all being said........anesthesia providers get reimbursed for services deemed medically necessary by the payer.
 
Thank you for your reply Michele. According to the anesthesiologist they are not performing other duties they are in the room monitoring vitals and availiable if anesthesia is needed. :confused:
 
It needs to be determined if they are fulfilling the requirements to bill for MAC anesthesia and if there is medical necessity for the same. Start with the payer policy.
 
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I appreciate all your help. I got a little more detail. The surgeons are requesting the presence of anesthesiologist in the room during the procedure. they are there bascially in case anesthesia is needed. They are not performing anything other than vitals. The drs want us to bill mac but how do i bill mac and not be pd as if i were actually giving anesthesia?
 
Help asap

I need to get someone who is willing to help me with a new client we have. We need a consultant either on site or remotely to assist us in making sure we are billing for our anesthesia and CRNA services in a small hospital setting. It is for the professional fee side only. I AM WILLING TO PAY A VERY GOOD CONSULTING FEE. It is dealing with the anesthesiologist medically directing CRNAs and making sure we are doing this right.
Any takers please call 901-210-3072 or guide me to someone who can. :)
 
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