ASA Crosswalks & Fees
Billing Anesthesia Services:Anesthesia services are billed using CPT® codes 00100-01999. These CPT® codes are cross walked to surgical codes. The crosswalks are available from the ASA American Society of Anesthesiologists through Find-A-Code. Using Find-A-Code you can crosswalk from CPT Anesthesia codes to Surgery and Procedure Codes and vice versa (see example below). You can also see CMS Base units and ASA Base Units. Example on Anesthesia Code 00515 Select the title to see a summary and a link to the full article. November 25th, 2019 Hypertension ICD-10-CM Code Reporting Table| Published November 25th, 2019 In ICD-10-CM, hypertension code options do not distinguish between malignant and benign or between controlled and uncontrolled. What is important for code selection is knowing if the hypertension is caused by or related to another condition. The following table shows some of these options. October 1st, 2019 Federal Workers Compensation Information| Published October 1st, 2019 When federal employees sustain work-related injuries, it does not go through state workers compensation insurance. You must be an enrolled provider to provide services or supplies. The following are some recommended links for additional information about this program.
Division of Federal Employees' Compensation (DFEC) website
Division of Federal Employees' Compensation (DFEC) provider ... September 30th, 2019 New Codes for Dry Needling| Published September 30th, 2019 Find out what you need to know about the new codes for dry needling, also known as trigger point acupuncture. August 16th, 2019 Medical ID Theft| Published August 16th, 2019 - Last Review/Update August 20th, 2019 Medical ID Theft
"So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ... August 9th, 2019 The OIG Work Plan: What Is It and Why Should I Care?| Published August 9th, 2019 - Last Review/Update August 14th, 2019 The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ... July 12th, 2019 5 Ways to Minimize HIPAA Liabilities| Published July 12th, 2019 - Last Review/Update July 30th, 2019 Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability.
Take ... May 13th, 2019 Electrical Stimulation and Electromagnetic Therapy Devices| Published May 13th, 2019 - Last Review/Update May 20th, 2019 Electrical Stimulation and Electromagnetic Therapy Devices can be used for pain, muscle atrophy, help spinal cord injuries, treat symptoms caused by other medical conditions and can be used in the treatment of wounds. This Regence BC/BS article lists codes and devices and gives guidance on coding from Medicare Advantage viewpoint. April 1st, 2019 Spinal Cord Stimulator Used for Chronic Pain| Published April 1st, 2019 Chronic pain is a condition that can be diagnosed on its own or diagnosed as a part of another condition. When coding chronic pain, there is no time frame defining when pain becomes chronic pain; the provider’s documentation should be used to guide the use of these codes.
ICD-10-CM Diagnosis Codes ... October 31st, 2018 Anesthesia and Pain Management| Published October 31st, 2018 - Last Review/Update November 1st, 2018
Anesthesia and Pain management is under close watch from the OIG according to a report from Anesthesia Business consultants, they stated, "The Health and Human Services Office of Inspector General (HHS OIG) reports in its most recent Semi-annual Report to Congress that in FY 2017 it brought criminal actions against 881 individuals or organizations ... October 17th, 2018 Wolters Kluwer Drug Pricing| Published October 17th, 2018 Wolters Kluwer provides unit and package pricing for multiple drug price types: Average Wholesale Price (AWP), Wholesale Acquisition Cost (WAC), Direct Price (DP), Manufacturer's Suggested Wholesale Price (SWP), Centers for Medicare & Medicaid Services, Federal Upper Limit (CMS FUL), Average Average Wholesale Price (AAWP), Generic Equivalent Average Price (GEAP). Average... May 14th, 2018 TKAs to Outpatient What We Have Learned with Q1| Published May 14th, 2018 - Last Review/Update May 24th, 2018 The release of the 2018 Final Rule for the Outpatient Prospective Payment System (OPPS) in November 2017 has created quite a stir across the orthopedic healthcare community. In what has been deemed a questionable decision, the Centers for Medicare and Medicaid Services (CMS) decided to remove Total Knee Arthroplasty... January 29th, 2018 Anesthesia Documentation Modifiers - Jurisdictions: J8A, J5A, J8B, J5B| Published January 29th, 2018 Documentation Modifiers direct prompt and correct payment of the anesthesia claims submitted. Documentation modifiers (AA, QK, AD, QY, QX and QZ) must be billed in the first modifier field.
If a QS modifier applies, it must be in the second modifier field. Processing delays and denials may occur for claims submitted ... January 29th, 2018 Anesthesia and Fee Calculation| Published January 29th, 2018 - Last Review/Update April 16th, 2020 Fees for anesthesia services are not calculated the same as for other types of procedures. There are four elements to consider when calculating anesthesia fees. Medicare accepts base units and time units; however, depending on the third party payer, they may or may not accept physical status units and/or qualifying circumstances units.
Base Unit (of the CPT code)
Time (in ... January 29th, 2018 Paravertebral Joint/Nerve Blocks - Diagnostic and Therapeutic| Published January 29th, 2018 According to Medicare article A50443, a facet joint level refers to the zygapophyseal joint or the two medial branch nerves innervating that zygapophyseal joint. Use CPT codes 64491 and 64492 in conjunction with 64490. Do not report CPT code 64492 more than once per day. Use CPT codes 64494 and 64495 in conjunction with 64493. Do not report CPT code 64495 more than once per day. For injection of ... January 24th, 2018 HIPAA and the Opioid Crisis| Published January 24th, 2018 HIPAA and the Opioid Crisis guidance released by HHS. January 10th, 2018 Paravertebral Joint/Nerve Denervation| Published January 10th, 2018 A facet joint is supplied by two medial branch nerves. Each medial branch nerve supplies sensation to one half of each facet joint above and below the spinal nerve of origin. Therefore, both of the two related medial nerve branches for each facet joint must be treated. The CPT codes 64635-64636 have a ... January 9th, 2018 Conscious (Moderate) Sedation| Published January 9th, 2018 Moderate (Conscious) sedation is a drug-induced state of relaxation in which the patient is typically awake and can respond to verbal commands, but might not be able to speak. A combination of medicines is used and often includes a sedative as well as an anesthetic to block pain. January 9th, 2018 Coverage and/or Medical Necessity for the Use of Hyaluronan or Derivitive| Published January 9th, 2018
According to Palmetto GBA, Medicare will cover the cost of the injection and the injected hyaluronate polymer for patients who meet the following clinical criteria:
Knee pain associated with radiographic evidence of osteophytes in the knee joint, sclerosis in bone adjacent to the knee, or joint space narrowing.
Morning stiffness of less than 30 minutes in duration or crepitus on motion of the ... January 4th, 2018 Acute Post-Operative Pain Management| Published January 4th, 2018 CPT codes 62320, 62322 should be used when the analgesia is delivered by a single injection.These codes should only be used when the catheter or injection is not used for administration of anesthesia during the operative procedure. Modifier 59 should be used when billing these services to indicate that the catheter or injection was a ... There are more articles. View all articles... View articles for the current subject by subtopic: Select the webinar title to view a summary and link to the webinar video. August 23rd, 2018 Coding and Auditing for Upper Extremity ProceduresIn this webinar, Aimee will review coding and auditing information for procedures commonly performed on the upper extremities and how to locate vital information that could help prevent coding errors and reduce risk in case of an audit. January 4th, 2018 Proper Coding and Billing for Drugs, Biologicals and InjectionsProper Coding and Billing for Drugs, Biologicals and Injections February 2nd, 2017 How to Check NCCI Edits Using FindACodeHow to Check NCCI Edits Using FindACode There are more webinars. View all webinars... View webinars for the current subject by subtopic: 2020 Pain Management ICD-10-CM Coding Book2020 Pain Management Reimbursement GuideAdvanced Beneficiary Notice of Noncoverage (ABN) Form Instructions ToolAmerican Society of Regional Anesthesia and Pain MedicineAnesthesia: All Standards, Guidelines & Practice ParametersBilateral Surgeries: Claim SubmissionClinical Practice Guideline for the Management of Substance Use DisordersCommonly Used Medicare Modifiers - GA, GX, GY, GZEye CodingFederal Opioid Treatment StandardsMedicare Part B Clinical Laboratory Fee ScheduleNoridian Anesthesia and Pain Management PoliciesNoridian Anesthesia and Pain Management ResourcesNoridian: Allowed Amount ReductionsOpioid Treatment ProgramsPhysician Assistant (PA) Resources NoridianPreoperative Evaluation and Preparation for Anesthesia and SurgerySummary of the HIPAA Privacy Rule by HHS |
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