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Anesthesia Billing: the Big Leagues of Medical Billing and Coding

Anesthesia Billing: the Big Leagues of Medical Billing and Coding

Anesthesia is one of the most difficult and complex medical specialties to bill for because of its exacting compliance requirements and highly specialized coding. Insurance claims in the Anesthesia specialty require exceptional levels of expertise in order to avoid denials, time-consuming resubmissions, and significant revenue loss.

A Quick Anesthesia Billing Workshop

Read the info. Take the quiz. Make a change.

Take a minute to look at these basics for anesthesia billing and coding, plus some additional areas that have to be addressed correctly in order to facilitate clean claims. Then check out the benchmarks and see how your practice is measuring up.

The Building Blocks of Anesthesia Billing

  • Base Units

    Base units determine the complexity of the anesthetic service being provided

  • Time Units

    The time spent by the anesthesiologist administering the anesthetic and monitoring the patient’s condition - before, during, and after the surgery (calculated by dividing the time spent delivering the service (in minutes) by 15)

  • Modifiers

    Two-character indicators that either modify payments or identify relevant details on a claim. Modifiers increase accuracy and coding consistency, and capture payment data

Additional Basics of Anesthesia Billing

Base and Time Unit Report
A report of time spent on the procedure by the minute
Stop and Start Time Compulsory documentation of start and stop time of the procedure

Multiple Procedure Codes
Some ASA codes contain multiple areas, and have a higher base value — essential for medical coders to know for maximized reimbursement

Use of Modifiers Modifiers supply additional information on the procedural coder. Appropriate modifiers must be used for all CPT codes

Medical Coding Qualifying Circumstance
Coding and qualifying circumstances that impact the administration of an anesthesia service — increasing the reimbursement rate of the claim

Also Super-important to Keep Current

  • Payer Contracts

    Payer contracts should be reviewed annually to ensure a practice is receiving fair-market value using the ASA’s annual payer survey results

  • ChargeMaster Monitoring

    Per-unit charges for services should be reviewed and updated regularly to align with insurance company fee schedules

  • ICD-10 Documentation and Coding Set

    Anesthesiologists depend on surgeons for a majority of patient information. Know what is compulsory and determine how best to acquire the data to accurately code using ICD-10.

The A+ Anesthesia Report Card

Average Days in AR

Best Practice: <40

Your Current:

Net Collection Rate

Best Practice: >96%

Your Current:

Aged AR% over 120

Best Practice: <12-15%

Your Current:

Denial Rate

Best Practice: <3-5%

Your Current:

Days from TOS to Billing

Best Practice: <5 Days

Your Current:

Claims Paid in <45 Days

Best Practice: 85-90%

Your Current:

Results are Everything

If your results aren’t measuring up, consider talking to Medusind. Our industry-leading technology, working in concert with our team of experienced Anesthesia billing experts, help practices significantly reduce A/R balances, increase revenue, improve efficiency, and lower overhead costs.

Medusind provides real-time metrics, customizable dashboards, and a dedicated account team that’s always available to answer questions and help solve issues whenever they arise. 

Find out more about Medusind’s Anesthesia billing, and help your practice perform at its best.



See how Medusind can work for you

Tell us about your business or organization and we’ll connect you with a Medusind expert who can show you the products in depth, and answer any questions you have. See how a provider, office manager, or biller use Medusind to empower their practice.

See How Medusind Can Work for You

Tell us about your business or organization and we’ll connect you with a Medusind expert who can show you the products in depth, and answer any questions you have. See how a provider, office manager, or biller use Medusind to empower their practice.

See How Medusind Can Work for You

Tell us about your business or organization and we’ll connect you with a Medusind expert who can show you the products in depth, and answer any questions you have. See how a provider, office manager, or biller use Medusind to empower their practice.