Tuesday, June 29, 2010

Anesthesia Billing for Obstetrics

Anesthesia Billing for Obstetrics 

In many cases the Anesthesiologist or the CRNA places the epidural and leaves the patients side once dosage has been tested, checking back only periodically throughout labor progression. Different anesthesia groups document this in varying forms. Due to widespread variances in the fee calculation of these services, tracking payment trends accurately is difficult. In the ASA Relative Value Guide there are four suggestions for anesthesiologists to consider when billing for neuraxial labor analgesia. When choosing one of these methods a group must first consider the payor mix for their area, the OB case volume as well as practitioner availability. The four options for accounting time units and fee calculation are:
  1. Base units + total patient contact time. (Insertion, managing adverse effects, delivery, removal) and one unit hourly.
  2. Base units + time units. (Insertion through delivery) subject to a reasonable cap.
  3. Single flat fee
  4. Single flat fee and incremental fees based on the number of hours involved. i.e. $500.00 flat fee and $200.00 for every hour over 5 hours.

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