tci Medicare Compliance & Reimbursement - 2012 Issue 13

Reader Question: Know CRNA Choices for Colonoscopy

Question: Is a certified registered nurse anesthetist (CRNA) allowed to bill Medicare for anesthesia during a colonoscopy? Are there certain requirements?Answer: Yes, a CRNA can bill Medicare for colonoscopy, although several carriers do not recognize anesthesia as medically necessary for endoscopies. If you file a claim, the correct code depends on the type of sedation administered.For general anesthesia or monitored anesthesia care (MAC), report 00810 (Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum). Reporting MAC is appropriate if the carrier recognizes that anesthesia service is medically necessary for the procedure or if you plan...

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