Wiki CRNA billing 11900

[missyah20]

Can a CRNA bill for code 11900 and get paid by Medicare? Our CRNA did an intralesional injection for a shingle lesion. Thanks!

 

[jdrueppel]

missyah20,

I have not personally billed this procedure for a CRNA but if the procedure is within scope of practice state licensure then it should be a covered service. You could also call your Medicare carrier for clarification.

Below is from the CMS Provider Manual - Section 140.

140.4.3 - Payment for Medical or Surgical Services Furnished by CRNAs
(Rev. 1, 10-01-03)
B3-16003.H
Payment can be made for medical or surgical services furnished by nonmedically directed CRNAs if they are allowed to furnish these services under State law. These services may include the insertion of Swan Ganz catheters, central venous pressure lines, pain management, emergency intubation, and the pre-anesthetic examination and evaluation of a patient who does not undergo surgery. Payment is determined under the physician fee schedule on the basis of the national physician fee schedule conversion factor, the geographic adjustment factor, and the resource-based relative value units for the medical or surgical service.

http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf

Julie, CPC