Earn More and Spend Less
Billing and coding for anesthesia services are unlike most specialties as it is much more challenging and complex and require expertise and appropriate tools. At Bristol Healthcare, our certified anesthesiology billers and coders, understand the complexity and importance of accurate billing and coding for successful revenue cycle management. We are dedicated to providing comprehensive and effective billing and coding services that help you streamline your revenue cycle and maximize your reimbursements.
Our staff is continuously trained and updated to keep up with the ever-changing codes, regulations, and guidelines to ensure that your billing and coding practices are compliant and your claims are submitted promptly and accurately. We also use the latest and most appropriate software tools for anesthesia billing.
Our coders and billers are well acquainted with:
- Medical Terminology: Our billers and coders have a thorough understanding of medical terminology, including medical abbreviations and acronyms.
- Anatomy and Physiology: Our professionals are familiar with anatomy and physiology to code procedures accurately.
- Techniques and Procedures: How to code for various types of anesthesia, including general, regional, and local anesthesia, as well as other anesthesia procedures such as epidurals and nerve blocks.
- Billing and Coding Guidelines: Our billers and coders have a deep understanding of the billing and coding guidelines specific to anesthesia services. They stay up-to-date with the latest updates and changes to ensure compliance with billing and coding regulations.
- Code Modifiers: Different modifiers and how to use them to prepare and submit clean claims.
- Qualifying Circumstances: Documentation relating to qualifying circumstances can be submitted to the payor if the services rendered are considered acceptable and needed. These additional codes can mean higher payment for the anesthesiologist or CRNA.
- Physical Status Modifiers: These are used for declaring a patient’s physical health at the time of a procedure. This increases the profitability of your facility.
- Base Units: Calculation of base units.
- Insurance and Reimbursement: We know how to submit claims to insurance companies and work with them to resolve any issues that may arise.
- Electronic Health Records and Medical Billing Software: With over a decade of experience, our billers and coders possess extensive expertise in more than 35+ software. They are adept at navigating electronic systems and software to ensure accurate billing and coding.
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Certified Resources
Our specialists are AAPC & AHIMA certified.
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HIPAA Compliant
All patient-related data is handled only by authorized personnel.
Our anesthesia billing and coding services are designed to set you up for success from the get-go.
- Accurate Coding and Billing: We use the latest technology and industry best practices to ensure that your claims are coded and billed accurately, reducing the risk of denials and delays.
- Compliance with Regulations: We stay up-to-date with the latest regulations and guidelines to ensure that your billing and coding practices are compliant and avoid costly penalties.
- Timely Submission of Claims: We understand the importance of timely submission of claims and work diligently to ensure that your claims are submitted promptly, allowing you to receive your reimbursements as soon as possible.
- Increased Revenue: Our services are designed to optimize your revenue cycle, increasing your collections and reducing your administrative burden.
- Personalized Support: We provide personalized support to meet your unique needs, and our team is always available to answer any questions you may have.
Schedule a Free Consultation
With our anesthesiology billing and coding services, you can focus on providing high-quality care to your patients, while we take care of your billing and coding needs. Contact us today to learn more about how we can help you streamline your revenue cycle and maximize your reimbursements.
Schedule ConsultationA Short Guide
Formula for Calculation
The cost of an anesthesia service is calculated based on the difficulty of the procedure, duration of the procedure, and other modifying factors such as the health of the patient.
The general formula is: Anesthesia Charge = (Base Units + Time Units + Modifying Units) x Conversion Factor
- Base Unit: Every anesthesia procedure has been assigned a code which has a base unit value. The base unit value indicates the difficulty and skill required for the procedure.
- Time Unit: Each procedure takes a certain amount of time. A time unit is generally 15 minutes in length but maybe 10-12 minutes, depending on the location.
- Modifying Unit: A modifying unit takes into account special conditions such as the patient's health/emergencies that affect the anesthesia plan and administration.
- Conversion Factor: This is the cost assigned to each unit and is specific to the location of the anesthesia provider administering the anesthetic care. This cost will vary across the United States.
Anesthesia Billing and Coding Process
Billing for anesthesia services involves assigning the appropriate codes to the services provided and submitting a claim to the insurance company for reimbursement. Here is an overview of some of the steps involved in our billing process:
- Determine appropriate anesthesia codes: We determine the appropriate anesthesia codes based on the type of service provided, the duration of the service, and any complications or adverse reactions. The codes used will depend on the type of anesthesia used, such as general anesthesia, regional anesthesia, or monitored anesthesia care.
- Assign appropriate diagnosis codes: In addition to the anesthesia codes, we also assign appropriate diagnosis codes based on the patient's condition or reason for the procedure. The diagnosis codes are used to justify the medical necessity.
- Calculate the anesthesia time: Anesthesia time is calculated from the start of anesthesia to the end of anesthesia, including the time for any pre-operative or post-operative care. The anesthesia time is used to determine the appropriate base units for the service provided.
- Determine appropriate billing modifiers: Depending on the circumstances of the procedure, we use specific billing modifiers to indicate any special circumstances, such as emergency services or unusual anesthesia services.
- Claim submission: Once the appropriate codes and modifiers are assigned, the claim is submitted to the insurance company for reimbursement. The claim includes all the necessary information, such as the patient's information, the services provided, the codes used, and any supporting documentation.
- Claim follow-up: We continuously follow up on the claims to ensure that it's processed correctly and that the reimbursements are received in a timely manner. If the claim is denied, we investigate the reason for the denial and take appropriate action to resolve the issue.
By following these steps, we ensure our clients get accurate and timely reimbursement for the services provided.
Denials in Anesthesiology Billing
Anesthesia billing claims can be denied by payors for various reasons, the major ones being:
- Inappropriate bundling
- Medical necessity
- Prior authorization
- Request for supporting documentation
- Time rounding & other underpayment scenarios
Our coders and billers will ensure that clean claims are submitted and denials are kept to a minimum. They will also ensure that there are no underpayments and that you are reimbursed to the maximum as per your contracts.
Commonly Used CPT and ICD Codes
The medical codes used in anesthesia coding are dependent on the specific procedure being performed, the anesthesia technique used, and the patient's medical condition. Below are some examples of the most commonly used codes in anesthesia:
- 00100: Anesthesia for procedures on the upper anterior abdominal wall.
- 00220: Anesthesia for procedures on the lower back and pelvis.
- 00300: Anesthesia for procedures on the upper leg and knee.
- 00400: Anesthesia for procedures on the lower leg, ankle, and foot.
- 00520: Anesthesia for procedures on the head and neck.
- 00600: Anesthesia for procedures on the upper arm and elbow.
- 00700: Anesthesia for procedures on the lower arm and wrist.
- 00810: Anesthesia for procedures on the upper abdomen.
- R07.89: Other chest pain
- R10.9: Unspecified abdominal pain.
- R53.81: Other malaise and fatigue.
- R55: Syncope and collapse.
- R64: Cachexia.
- Z98.89: Other specified post-procedural states.
- Z95.5: Presence of other cardiac and vascular implants and grafts.
