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I have never done any coding for this field. How does one calculate the base unit? Is this something the Dr. tells you or do you determine it based on the time spent?
The base units can be found in the Relative Value Guide published by the ASA (American Society of Anesthesiologists). It takes all the anesthesia codes from CPT and lists assigned base units for each. It also goes into more detail regarding anesthesia billing practices than the CPT does. I would not recommend coding anesthesia charges without it. Also, as mentioned above... you need the Crosswalk also published by the ASA, it crosses all cpt codes, which can be crossed, to the appropriate ASA code(s).
Anesthesia is billed by a combination of base units plus time units. for example: if an asa code's value is 3 and the surgery took 1 hour, you would use 3 base units plus 4 15 min time units: 3+4=7 X rate
The rate can range from about $50 up to about $75 per unit.
This is why it's important to know the base units so that you can choose the code with the highest value.
When filling out the CMS 1500 electronically, in 24G (Days/Units), do you put the total time or the UNIT=Base unit+ Time unit?
Also, do we have to put the start time and end time in Box 19 of the CMS 1500?
I have a client that is a owns a Gastroenterology Clinic and a ASC. They are hiring two non-directed CRNA's to handle the Anesthesia for their cases. My questions are two fold
1. They are currently contracted with all major insurance carriers under the anesthesia group they work for. So I will be getting their contracts moved to either the client's Gastro Practice TAX ID or the Endoscopy Tax ID. Does it make any difference when billing and coding if I put them under the Medical Practice or the ASC?
2. Currently to we bill the ASA codes or the crosswalk CPT codes?
I'm not sure about the enrollment questions. As for # 2 most carriers require that you bill ASA codes with time for anesthesia services; however, some still want CPT codes. So the best thing to do is review your carrier's anesthesia policies and bill according to what they prefer. The major carriers like Medicare, Medicaid, Blue Cross, United Health etc... are going to want ASAs. You'll also want to review anesthesia modifiers, an undirected CRNA is billed out with a QZ mod.