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Anesthesia Basic units & time units
Are the basic units plus time units added together and both reported on the 1500 claim or just the time units.? Would the total charge include basic & time units for CPT® codes 00810 & 00740 at the conversion rate with medicare and all other insurances?
This is confusing as we have never done billing for anesthesia endoscopy for CRNA w/medical supervison and Doctor medically supervising. We have our own Surgery Center.
re: Anesthesia Basic units & time units
Medicare:The formula to calculate the allowed amount for anesthesia is:
(Base Units + Time (in units)) x CF = Anesthesia Fee Amt
Actual anesthesia time in minutes is reported on the claim. For example, 17 minutes of anesthesia is submitted to Medicare as '0017' in the units field (Item 24G of the CMS 1500 claim form. Carriers compute time units by dividing reported anesthesia time by 15 minutes (17 minutes = 1.13 units).
Note: This method is used to calculate anesthesia services that are 'personally performed.' Services that are 'medically directed' are reimbursed at 50 percent of the amount received if the service was personally performed. To find the definitions of 'personally performed', 'medically directed,' and to learn about other payment exceptions, please refer to Sections 50.B – 50.F of CMS Pub.100-04, Chapter 12.
re: Anesthesia Basic units & time units
QX - CRNA service; with medical direction by a physician;
QY - Medical direction of one certified registered nurse anesthetist by an
anesthesiologist;
QZ - CRNA service: without medical direction by a physician