Tuesday, September 13, 2016

Anesthesia Billing Guidelines Reminder and Reference



The following is a reminder of the billing guidelines for anesthesia services for  UnitedHealthcare Community Plan:

 Anesthesia Services - General or monitored anesthesia management services must be
submitted with a CPT anesthesia code 00100-01999, except 01953 and 01996. Refer to
the Anesthesia Management Codes in the Anesthesia Policy for all applicable codes.

 Time Reporting – Consistent with Centers for Medicaid & Medicare Services (CMS)
guidelines, time-based anesthesia services must be reported with anesthesia time in oneminute increments. For example, if the anesthesia time is one hour, then 60 minutes
should be submitted.

 Anesthesia Modifiers – All services reported for anesthesia management must be
submitted with the appropriate HCPCS modifiers. These modifiers identify monitored
anesthesia and whether a procedure was personally performed, medically directed or
medically supervised. Consistent with CMS guidelines, the allowance will be adjusted by
the modifier percentage indicated in the table in the Anesthesia Policy.

Claims not submitted per the Anesthesia Policy are subject to denial.

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