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This is a reminder of the billing requirements for anesthesia services.
Unless otherwise noted, time must be reported
for anesthesia services in minutes. If the provider?s anesthesia service is
interrupted for a short duration, the total
number of minutes should be reported, less the number of minutes representing
the interruption.
AmeriHealth applies the following standard anesthesia calculation formula to
determine reimbursement for eligible
anesthesia services reported in minutes:
- Reported anesthesia time units ? 15 minutes (round the time units to one
decimal place) = Time unit
- Time unit + base unit + modifying unit (if applicable) x conversion factor
= Reimbursement
Do not report base units with an anesthesia procedure code because
AmeriHealth calculates the reimbursement using
the Centers for Medicare & Medicaid Services (CMS) anesthesia base units.
For additional information about billing for anesthesia services, refer to
Claim Payment Policy #00.01.14k: Reporting
and Documentation Requirements for Anesthesia Services, which is available at
our AmeriHealth Medical Policy
Portal.
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