tci Part B Insider - 2003 Issue 5

INDUSTRY NOTES: Value Anesthetic Add-Ons Properly, CMS Tells Carriers

Carriers must recognize both base units and time units for primary and add-on anesthesia codes, the Centers for Medicare & Medicare Services instructs in transmittal B-03-017. Some third-party payers have different policies for handling time units for obstetrical anesthesia than for other anesthesia codes. CMS is worried that carriers' systems may consequently undervalue the time units of obstetrical add-on codes. Medicare uses an arcane formula to pay for anesthesia codes. It pays for the code-specific base unit value plus anesthesia time units multiplied by a locality-specific anesthesia conversion factor, CMS explains. If a physician performs more than one anesthesia...

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