Anesthesiology practices and procedures are extremely susceptible to audits as it involves complicated billing practices. The billing, coding, and time factors are the primary issues for the Medicare audits often leading to thorough government investigation and consequent clampdown on funds for allegedly using them inappropriately. Anesthesiology is very much under the constant vigilance of medical auditors.

You must keep in mind that anesthesiology billing is pretty much an objective procedure which is known to have a fixed set of guidelines for minimizing the margin of error. Get in touch with competent medical billing services like Anesthesia Services, a LTD company for error-free medical billing. Here are some important factors to consider for medical billing related to anesthesiology.

Bill Time: A common issue with anesthesiology billing seems to be the usual practice of billing time before the in-room time, and also billing time post out-of room time. As per Medicare, the perfect way to define anesthesia time is actually the entire period when the practitioner whether CRNA, AA, or the physician is actually physically present with his patient, and it is supposed to end at the time when the practitioner ceases to provide anesthesia services to his patient, for instance, when the patient could be transferred safely to post-operative care.

Time Factor: In anesthesiology, the time factor is just the same as other practices. Billing procedures are chiefly related to valid billable hours, right from the start time till the finish, and rounding-off time. As medical practitioners generally are paid a substantial hourly rate, the rounding off time also seems to be a major apprehension.

Coding: Maintaining good communication between anesthesiologists and the medical billers is of vital importance. It is mandatory for the anesthesiologists to communicate clearly with medical billers to make sure that a well-documented and accurate billing is done. Auditors would be suspecting foul play if they are provided with insufficient documentation. Moreover, it is critical to maintain consistency in coding so that they are not mistaken to be false claims.  Tagging of procedures and proper coding would be providing sufficient support to your billing claim.

Base Unit: Every anesthesia CPT Code (Current Procedural Terminology) would be having its own value assigned as per the degree of complexity of the clinical procedure performed. According to Medicare, base units are supposed to be the most critical parts of any anesthesia service and so are very much included in all the procedures. Remember base units are actually billed separately.

Special Units: These are supposed to be the additional units which could only be added provided certain specific conditions are fulfilled. These special conditions are known to impact the complete billing units. Anesthesiologists would be earning special units if a patient’s anesthesia process becomes pretty complicated because of total body hypothermia, extreme age, controlled hypotension and other emergency conditions.

Conclusion

Patients about to undergo surgery would be consulting their anesthesiologist and such consultations would be very much regarded as a part of the overall anesthesia procedure. Pre-surgery consultations are not billable separately. However, when you consult your anesthesiologist, regarding post-operative pain management then, it would be a completely separate case. Anesthesiology procedures are referred to as personally-performed when the anesthesiologist seems to be constantly involved in every step of the way of a single case.

If you are being billed for any personally performed procedure, then in that case, the physician is not expected to leave the operating room where your procedure is in progress. He cannot attend to a different patient then. If he does, the patient cannot be billed as per a personally-performed procedure. We have discussed the fundamental guidelines associated with medical billing precisely for anesthesiology. Follow them for an error-free and effective medical billing meant precisely for anesthesiology.