Mastering Time-Based Anesthesia Billing: A Guide to Boost Accuracy and Revenue

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  Anesthesia billing is a unique and intricate component of medical billing that differs significantly from other specialties. Unlike procedures billed on a per-service basis, anesthesia is often billed based on the duration of the service—making time-based billing a critical factor in accurate reimbursement. Let’s break down what time-based anesthesia billing entails and how practices can optimize their billing processes to avoid costly errors and delays. What is Time-Based Anesthesia Billing? Time-based anesthesia billing involves calculating charges based on the total time the anesthesiologist spends with a patient. This typically includes: Preoperative preparation Administration and maintenance of anesthesia Post-anesthesia care until the patient is no longer under the anesthesiologist’s care The billing formula generally looks like this: Total Units = Base Units + Time Units + Modifying Units Base Units : Determined by the specific surgical procedure perfor...
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Ambulatory Surgical Center Terminated Procedures

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Ambulatory Surgical Center Terminated Procedures

The following guidance determines the appropriate ambulatory surgical center (ASC) facility payment for a scheduled surgical procedure that is terminated due to medical complications, which increase the surgical risk to the patient.

  • Payment is denied when an ASC submits a claim for a procedure that is terminated before the patient is taken into the treatment or operating room
  • If the surgery is canceled or postponed because the patient on intake complains of a cold or flu
  • Payment is made at the rate of 50 percent if a surgical procedure is terminated due to the onset of medical complications after the patient has been prepared for surgery and taken to the operating room but before anesthesia has been induced or the procedure initiated For example If the patient develops an allergic reaction to a drug administered by the ASC prior to surgery. Modifier 73 should be utilized to indicate that the procedure was terminated prior to the induction of anesthesia or the initiation of a procedure.
  • Full payment for the surgical procedure is made if a medical complication arises that causes the procedure to be terminated after anesthesia has been induced or the procedure initiated. Modifier 74 should be used to indicate that the procedure was terminated after the administration of anesthesia or initiation of the procedure.

To know more about the Ambulatory Surgical Center Terminated Procedures, click here: https://bit.ly/3nQJ03J Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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