Anesthesia billing can be hard to understand -- and even harder to keep up with. From revenue cycle management to coding, it’s almost inevitable that something will fall through the cracks (unless you hire a third-party company to handle it for you, of course).
Here, we’ve broken down the anesthesia billing process into three components to give you an idea of what it looks like at its most basic level. However, it’s important to note that this is not an exhaustive guide to anesthesia billing; it’s simply a starting point.
With that said, let’s take a look at the ABCs of anesthesia billing.
A: Add It Up
Anesthesia practices determine how much they should get paid by using a formula, so knowing the formula is a great place to start:
Base Units + Time Units + Modifying Units = Total Amount Billed
Base units are the first component to the formula. For most surgical procedures, a basic value is assigned by the ASA depending on the difficulty of the surgical procedure. The value for all usual anesthesia services is included in this, except the time actually spent in anesthesia care, along with any modifiers.
B: Beginning Time
Time is the second component to the formula. It’s essential to know the exact moment you should start billing for anesthesia services because you’ll have to report it accurately and make sure it matches across all reports, charts, and bills.
According to the Medicare Anesthesia Manual, “Anesthesia time begins when the anesthesia provider starts to prepare the patient for the procedure and remains one to one with the
patient. Normally, this service takes place in the operating room, but in some cases, preparation may begin in another location (i.e., holding area). Anesthesia time is a continuous time period from the start of anesthesia to the end of an anesthesia service, when the patient is released to recovery.” Your start time should be consistently reported across all documents and bills.
Of course, you also need to keep up with anesthesia start time and stop time, and remember that any break in anesthesia time cannot be billed.
C: Consider Modifiers
Modifiers are the third component to the formula. Your modifiers are extremely important, as they communicate everything from the condition of the patient to what type of anesthesia service the patient received.
The appropriate modifiers must be applied to claims in order to ensure the correct reimbursement amount. Obviously, if this is not done correctly, things can get complicated very quickly.
Ready to Outsource Your Anesthesia Billing?
MBM understands all the ins and outs of the anesthesia billing process. When it comes to coding, revenue cycle management, and A/R, it pays to have an experienced third-party service provider like MBM handle everything for you so that you can focus on your patients and your practice. Ready to talk to us about managing your billing process? Contact us today!