Friday, August 6, 2010

Anesthesia payment when multiple anesthesia services and using with modifier

MULTIPLE ANESTHESIA SERVICES

Same Operative Session
Payment can be made for anesthesia services associated with multiple surgical procedures. The payment is based on the anesthesia procedure with the highest base unit value. The time units will equal the actual anesthesia time for both procedures.

Example:
Provider Date of Service Procedure Time Base Units
ABC 01/01/2009 00700 AA 2 hours 4
ABC 01/01/2009 00730 AA 1 hour 5

Payment for the multiple procedures will be based on code 00730, which has the highest base unit value, plus a total time period of three hours.

Modifier 76 – Repeat Procedure or Service by Same Physician
The patient is returned to the operating room on the same day for the same or a related procedure. The same physician who is performing the repeat service should bill the repeat procedure with the 76 modifier.

Example:
Provider Date of Service Procedure Modifier 
ABC 01/01/2009 00740 AA – First Service
ABC 01/01/2009 00810 AA, 76 – Repeat Service

Modifier 77 – Repeat Procedure by Another Physician
When a patient is taken back to surgery on the same day for the same or a related procedure by a different physician than the physician who performed the first service, submit the repeat procedure with the 77 modifier.

Example:
Provider Date of Service Procedure Modifier 
ABC 01/01/2009 00740 AA – First Service
XYZ 01/01/2009 00810 AA, 77 – Repeat Service

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