Summary: Recent changes within the American Society of Anesthesiologists' Relative Value Guide (RVG) signal a shift in payment for a key category of services. How is this shift affecting your reimbursement, and are there strategies for fending off revenue reductions? Today's article addresses these important questions.Each year the American So...

Summary: Determining the anesthesia mode can occasionally get complicated—both for the provider and the billing staff. Some situations can lead to unintended consequences, especially where a combined anesthetic is involved. It is important, then, for our readers to recognize the principles for correctly discerning and documenting the anesthesia te...

Summary:  The balance between providing excellent care and receiving reasonable reimbursement continues to be a tenuous proposition for anesthesia practices. As groups search for the best model and the best practices, there are daunting obstacles to overcome.There are two common misconceptions that hospital administrators frequently use to ta...

Summary:  Listing the anesthesia mode—or technique, as it is often called—is not as straightforward as it may seem. There are a few nuances to consider in terms of anesthesia record documentation, claims submission and payment.Learning the etymology behind certain phrases and words can be most enlightening. Studying the development of, and re...

Summary: Business models are constantly shifting and that holds true for the healthcare sector, as well. Can the success of digital-age startups such as Uber be translated to today's anesthesia specialty? The article below explores the possibilities.Uber has dramatically transformed the taxi business. We no longer talk of grabbing a cab; we "Uber" ...

Summary:  Medicare has opened up new locations for hundreds of procedures that had previously been relegated to the inpatient or hospital setting, generally. This will have an impact on anesthesia providers as there will be an increasing need for their services in alternate settings.On the move—that's the story of mankind, isn't it? From prim...

Summary:  The documentation of transesophageal echocardiography poses a number of interesting questions as there are a number of procedural options. As billing guidelines often change, it is always useful to review the current state of CPT and payer policy. There was a time, not too long ago, when cardiovascular anesthesiologists relied on th...

Summary: For the last several years, Medicare has increasingly placed an emphasis on a pay-for-performance model of reimbursement. It began with various incentive programs, such as PQRS, and continues with today's MIPS and alternative payment models (APMs). In the near future, new twists on this theme will emerge. Today's article touches on ...

​Physician Anesthesia ServicesWhen the anesthesiologist personally performed services. Report anesthesia services personally performed by the anesthesiologist with modifier AA. Medically DirectedWhen the anesthesiologist is involved in specific aspects of anesthesia services performed by other qualified individuals, the services are con...

Summary: 2020 was a very exceptional year. The coronavirus had a profound impact on the U.S. economy, American medicine and the specialty of anesthesia. While case volumes have recovered for most clients, the implications of the canceling of elective cases in March proved to be one of the ultimate practice management challenges. A careful review o...

Summary:  There are several new rules for 2021 that either directly or peripherally involve the practice of anesthesia or interventional pain. This article lists some of the provisions found in the 2021 Medicare PFS Final Rule that will be of interest to many of our readers. In previous weeks, we have attempted to summarize for you some of th...

Summary: There is often a cause-and-effect relationship between higher utilization and lower reimbursement within the healthcare sector. This relationship is coming into sharp focus with the surge of seniors now entering the Medicare program.Baby boomers are increasingly entering the rolls of Medicare. While many of them lead healthy and activ...

Summary: The recent passage of the Consolidated Appropriations Act provides a modicum of consolation for providers who had been preparing for major cuts in Medicare reimbursement. While the legislation does not reverse these cuts, they have been significantly pared down to a more manageable level. Over the last several months, the American pe...

SUMMARY: There are changes every year to the coding guidelines as found in the CPT manual. For 2021, the primary changes will revolve around certain evaluation and management services.With every new year, there arises within us the hope of better days ahead—a certain optimism fostered by a clean slate and a wide-ranging set of possibilities. New Ye...

Summary: Telehealth will continue to be a viable option for many providers and patients; but how applicable will these services be to the practice of anesthesia and chronic pain?During the course of this year, the Centers for Medicare and Medicaid Services (CMS) produced a number of rule changes concerning the utilization of telehealth servi...

Summary:  The initial information coming out of the massive 2021 PFS Final Rule provides little to celebrate for anesthesia providers. From a financial standpoint, the Final Rule has dealt the anesthesia specialty a stinging blow.The Centers for Medicare and Medicaid Services (CMS) has released its Medicare Physician Fee Schedule (PFS) Final ...

Summary: As your billing company, we work hard to schedule and conduct documentation in-services. These sessions are critical in that they provide a unique opportunity to see billing guidelines in context and promote better documentation habits, ensuring optimal billing for services provided. Unfortunately, these sessions are often underattended. ...

Summary: New regulations have been released that will update and clarify the provisions of the Stark Law--the set of measures that address physician self-referral in connection with Medicare and other federal healthcare program services. In the ancient past, stargazers assumed that the celestial bodies visible at night numbered a little over a tho...

Summary:  CPT codes often take time to be established. Many new nerve blocks are still unlisted, even though they are now used quite commonly. Providers should not be discouraged from trying new techniques just because they may be unpayable. The process of establishing new codes may be slow, but it does eventually include valuable services. T...

Summary: The anesthesia community is anxiously awaiting some word on Medicare payment rates for 2021, and providers are wondering how the second wave of COVID will affect their overall income in the coming year. Despite all this uncertainty, there remains reason for hope.There is nothing more unsettling than not knowing. That is especially true whe...