Anesthesia billing reminder

As a reminder, anesthesia when performed by the same physician who performs the medical or surgical service is not separately reimbursable. The only exception is moderate sedation if:

• Medicare's National Correct Coding Initiative (NCCI) does not deny the moderate sedation code as included in the primary procedure.
• Regence's Correct Code Editor (CCE) does not deny the moderate sedation code as included in the primary procedure.
• The primary procedure is not listed in Current Procedural Terminology (CPT^®) Appendix G (Summary of CPT Codes that Include Moderate [Conscious] Sedation).

We will continue to monitor submitted claims to assure consistency with our existing reimbursement policy.  

Our Anesthesia Services Reporting (Anesthesia #101) reimbursement policy outlines our process, which is consistent with the Centers for Medicare & Medicaid Services (CMS) guidelines.


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