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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Common Outpatient Rehabilitation Therapy CERT Errors

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Billing Part B Outpatient Therapy Services

Outpatient rehabilitation therapy includes Physical Therapy (PT), Occupational Therapy (OT), and Speech-Language Pathology (SLP) services. Medicare covers outpatient PT, OT, and SLP services when:

  • A physician or Non-Physician Practitioner (NPP) certifies the “treatment plan,” called the Plan of Care (POC), ensuring:
    • A patient needs therapy services 
    • POC is: 
      • Established by a physician, NPP, our qualified therapist provides services 
      • Reviewed periodically by a physician or NPP 
    • A patient gets services under physician care 
  • POC certifying the provider’s name and NPI is on the claim 
  • Providers meet medical necessity, documentation, and coding requirements

where, 

  • CERT: Comprehensive Error Rate Testing
  • A physician is a Doctor of Medicine, osteopathy, podiatric medicine, and optometry (only for low vision rehabilitation). 
  • NPP includes a Physician Assistant (PA), Clinical Nurse Specialist (CNS), or Nurse Practitioner (NP). 
  • A qualified Therapist includes a PT, OT, or SLP who meets regulatory qualifications as applicable, including state licensure or certification.

Common Outpatient Rehabilitation Therapy CERT Errors

  • Missing certification and recertification(s): Physician’s, NPP’s, or therapist’s dated signature(s) approving the POC. Prevention: Confirm physician or NPP certified the POC (and recertified it when appropriate) with their signature and date.
  • Missing signature: Physician, NPP, or therapist who developed the POC and established treatment plan date. Prevention: Ensure you add your dated signature and professional identification (for example, PT, OT).

To learn more about Common Outpatient Rehabilitation Therapy CERT Errors, click here: https://bit.ly/3qSdiEY Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

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