Anesthesiologist Billing Codes Will Increase in 2013
Changes are coming to anesthesiologist billing that will slow the process down. Insurance companies already don’t make it easy to have your claims paid, but the process is getting even more difficult in 2013.
Anesthesiologist billing codes are always changing so stay posted to make sure you are on top of them. Anesthesia Resource can provide anesthesiologist with the resources and support they need to handle all their billing needs.
The International Statistical Classification of Diseases and Related Health Problems (ICD-9) currently contains 17,000 billing codes to choose from in order to classify diseases and a wide variety of symptoms, causes, and other variables. On October 1, 2013, the number of codes will increase to 155,000 under the ICD-10.
Changes in the anesthesiologist billing codes
- ICD-10-CM codes will have three to seven digits.
- Digit one is alpha (A-Z, not case sensitive).
- Digit two is numeric.
- Digit three is alpha (not case sensitive) or numeric.
- Digits four to seven are alpha (not case sensitive) or numeric.
These changes and others mean that the diagnosis codes you are used to reporting will no longer be there. Many diagnosis codes will include more details than their present counterparts, and some sub-codes of the family will even move to different locations.
There will need to be significant education and training for coders, billers, practice managers, physicians and other health care personnel to fully implement this major code change. According to AACP, ICD-10 will change everything. They also said the big differences between the two systems are ones that will affect billing for information technology and software for anesthesiologist practices.
The U.S. Department of Health and Human estimates that “the percent of returned claims may peak at around six percent to 10 percent of the pre-implementation levels” for the first three to six months post-implementation, and that practices will experience elevated claims-processing costs for the first three years of the implementation of these new anesthesiologist billing codes.
CD-10 is currently active in almost every country in the world, except the United States. The ICD-9 code set is more than 30 years old and is obsolete. One good thing about the new anesthesiologist billing codes is that studies find them to be more logical. Other benefits of the system include the following:
- More-accurate payments for new procedures.
- Fewer miscoded, rejected, and improper reimbursement claims.
- Better understanding of the value of new procedures.
- Improved disease management.
- Better understanding of health care outcomes.
According to estimates by the Medical Group Management Association, the average cost of upgrading to ICD-10 for a three-physician practice will be $84,000 for a practice that does all of its own billing and management.
Overall, the new rules will require more work for awhile. And more work means less time for you and your practice. As an anesthesiologist, why not outsource your billing to someone who has the knowledge to make the switch without slowing down the process and costing your practice money?
Anesthesia billing companies will be sure to have their systems updated and staff trained so they can continue to help their clients save money and time.
Contact us today and let us help you with your anesthesiologist billing needs.
Anesthesia Billing Service: 3 Differences from General Procedures
Billing for anesthesia service is a complicated process. It’s different from the billing process of general procedures. The codes and requirements are also always changing.
Most patients are covered by insurance and have provided these details to the physician beforehand. The responsibility then lies with the physician to submit claims in order to get paid. Companies that provide anesthesia billing service, like us at Anesthesia Resource, are aware of the differences, including the following:
- Procedures must be followed properly to ensure that medical direction is covered.
An anesthesiologist can direct up to four CRNAs or residents at the same time, but they must meet certain criteria in order for medical direction to be reimbursed by the insurance payer. The criteria for a successful anesthesia billing includes seven steps:
- Perform a pre-anesthesia exam and evaluation.
- Prescribe the anesthesia plan.
- Personally take part in the most demanding procedures of the anesthesia plan, which includes
induction and emergence. - Be certain that any procedures in the anesthesia plan that he doesn’t perform are performed by a
qualified CRNA. - Monitor the course of the administration of anesthesia in intervals.
- Be physically present and available for immediate diagnosis and treatment of emergencies.
- Provide the post-anesthesia care indicated.
- Concurrency, which is defined as the maximum number of procedures that the provider is medically directing within the context of a single procedure and whether the other procedures overlap each other.
A provider can either be medically directing or supervising. A physician who is providing Medical Direction in concurrent cases cannot ordinarily be involved in furnishing additional services to other patients.
If the medical professional leaves the immediate area of the operating suite for a long time or devotes extensive time to an emergency case or is otherwise not available to respond to the immediate needs of the surgical patients, the physician’s services to the surgical patients are supervisory in nature and are not billable as Medical Direction.
If you don’t explicitly document changes and processes, your anesthesia service billing could be audited.
- The physical status of the patient. Many anesthesia procedures are performed under difficult circumstances when the patent’s physical status is impaired. It’s important to know proper physical status modifiers. Qualifying circumstance also adds to the complexity of the anesthesia procedure and is reported by using qualifying circumstance codes. The ASA has a Physical Status Classification System. Their system has six categories:
- A normal healthy patient.
- A patient with mild systemic disease.
- A patient with severe systemic disease.
- A patient with severe systemic disease that is a constant threat to life.
- A moribund patient who is not expected to survive without the operation.
- A declared brain-dead patient whose organs are being removed for donor purposes.
The documentation must be detailed and complete in order to secure reimbursement.
The difficulty of making sense of all the differences and specifics of anesthesia billing is why companies provide this service. We want to make your life easier by taking care of the technical and administrative details for you, allowing you to grow your business.
Contact us today and lets talk about becoming your anesthesia billing service.
