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Billing requirements for anesthesia claims

August 28, 2014

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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.

IBC 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 IBC calculates the reimbursement using the Centers for Medicare & Medicaid Services anesthesia base units.

For additional information about billing for anesthesia services, refer to Claim Payment Policy #00.01.14: Reporting and Documentation Requirements for Anesthesia Services, which is available at our IBC Medical Policy Portal.

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