West Virgina Medicaid
Anesthesia services covered by WV Medicaid include general, regional, and labor epidural. These
services are primarily reimbursed using the American Society of Anesthesiologist’s (ASA) “0” CPT
codes. Supportive services rendered in order to afford the member the necessary anesthesia care are
also covered.
Anesthesiologists and Certified Registered Nurse Anesthetists (CRNAs) are the only providers that
may be reimbursed for general and monitored anesthesia services.
BASE AND TIME UNITS
Two distinct unit values apply to anesthesia services. Base units are defined by the ASA Uniform
Relative Value Guide. These units are part of the procedure and may not be billed separately.
The other value is the time unit. WV Medicaid defines a time unit as 15 minutes which must be
rounded to the nearest whole unit. (Eight minutes or more, round up. Seven minutes or less, round
down.) Only time units may be billed.
Payment is determined by the sum of the ASA base units plus time units multiplied by the anesthesia
conversion factor. There is a limit of 40 units (10 hours) on each anesthesia Zero “0” code, except for
maternity-related anesthesia services. (See Section 519.8.3.) If anesthesia is provided longer than 10
hours, the claim must be billed on paper and submitted with documentation that would justify the
additional anesthesia used.
Know Anesthesia billing claim guidelines and rules for getting payments. How to bill the anesthesia claim in the correct manner without time delay. Medicare Anesthesia billing and coding. procedure code list , procedure codes.
Wednesday, August 11, 2010
Subscribe to:
Post Comments (Atom)
Popular Posts
-
Billing Modifiers The following modifiers are used when billing for anesthesia services: • QX - Qualified nonphysician anesthetist wit...
-
Anesthesia services are provided under difficult circumstances which may affect the condition of the patient, or present unusual operative c...
-
CPT NEW DESCRIPTION 64633 DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE(S), WITH IMAGING GUIDANCE (FLUOROSCOPY OR CT)...
-
cpt code and description 64450 - Injection, anesthetic agent; other peripheral nerve or branch - average fee amount - $80 - $100 64405 ...
-
CPT code and description 64479 - Injection, anesthetic agent and/or steroid, transforaminal epidural; Cervical or Thoracic, single level ...
-
Lumbar puncture Procedure code and Description 62270 T Spinal puncture, lumbar, diagnostic 0206 $373 $204 62272 T Spinal puncture, the...
-
Procedure code and Description 00640 (Investigational) ANESTHESIA FOR MANIPULATION OF THE SPINE OR FOR CLOSED PROCEDURES ON THE CERVICAL...
-
ANESTHESIA REIMBURSEMENT METHODOLOGY Code Description Comments 01960 Anesthesia for vaginal delivery only ...
-
EPSDT DENTAL PROGRAM Dental Hospital Calls and Sedation Policy Revisions D9230 NITROUS OXIDE – analgesia, anxiolysis, inhalation of nitr...
-
procedure code and description 69436 - Tympanostomy (requiring insertion of ventilating tube), general anesthesia - average fee payment...

No comments:
Post a Comment