How incorrectly documenting your anesthesia service can cost you your reimbursement

Correctly listing the details of anesthesia services is critical for claims submission and payment, according to a blog post by Tony Mira, founder of Anesthesia Business Consultants, a MiraMed company.

There are three officially recognized modes of anesthesia from a billing and compliance perspective:

  1. Regional anesthesia: The use of local anesthesia to block pain from a large part of the body — spinal, epidural or block anesthesia. 
  2. General anesthesia: Anesthesia administration where the patient loses consciousness or the ability to purposefully respond. 
  3. Monitored anesthesia care: When anesthesia providers are asked by surgeons to stand by in the event a patient needs to be put under.

When documenting regional anesthesia, it's important to provide specifics on the type and location of a regional block. The full details of the regional block or blocks can be helpful in determining what may or may not be billed.

Many payers don't provide reimbursement for MAC. In many MAC cases, however, a sedation drug like propofol is used and a patient loses consciousness, and MAC cases become general anesthesia cases intraoperatively. If the MAC ends up being general anesthesia, Mr. Mira recommends reflecting this in documentation so payers are more likely to reimburse. 

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