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Anesthesia Billing Guide
- Anesthesia Billing Codes
- Anesthesia Billing Modifiers
- Anesthesia
- Concurrent, Medical Direction and Supervision
- Daily Management and Pain Management
- Group/Member Practice Responsibilities
- Local Coverage Determinations
- Moderate (Conscious) Sedation
- Monitoring Anesthesia Services
- National Coverage Determinations
- Payment and Reimbursement
- Provider Qualifications
- Teaching Anesthesiology Services
- Resources and References
- Related Articles
Group/Member Practice Responsibilities
Table of Contents
Members of a Group
If anesthesiologists are in a group practice, one physician member may provide the pre-anesthesia examination and evaluation while another fulfills the other criteria. Similarly, one physician member of the group may provide post-anesthesia care while another member of the group furnishes the other component parts of the anesthesia service.
The medical record must indicate the services furnished and identify the physicians who furnished them.
Note: However, only one member of the group would bill for the entire anesthesia service.
More than One Teaching Physician
If more than one teaching anesthesiologist in the anesthesia group is present during the key or critical periods, the NPI of the teaching anesthesiologist who started the case must be indicated in the appropriate field on the claim.
A teaching anesthesiologist in a group practice would put their NPI in claim field number 24 or the electronic equivalent (as the rendering physician) and the NPI of the group would go in field number 33 or the electronic equivalent.
The patient’s medical record documentation must indicate the teaching physician’s presence during all critical or key portions of the anesthesia procedure and the immediate availability of another teaching anesthesiologist as necessary.
The teaching anesthesiologist should use the “AA” modifier (anesthesia services performed personally by anesthesiologist) and the “GC” certification modifier (the teaching physician was present during the key portion of the service and was immediately available during other parts of the service) to report such cases.
Related Content
Revised 10/25/2024