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Tuesday, August 30, 2016
How to Bill Anesthesia
Hi, I received a claim for anesthesia (CPT 00170)with two lines billed for this. Each line was billed for 1 unit. I`m not sure if you`re familiar with anesthesia coding, but the base units for this code is 5, therefore the minimum amount of units would be 6. I requested the anesthesia records for start/stop time to determine the # of minutes and, therefore, the # of units. The total # of units should be 10. Why would the DDS bill for two lines? Do I deny the second line and change the # of units on the first to 10? Thanks, in advance, for your help.
I can't be sure why anyone does what they do, but I suspect that his insurance folks are used to dental insurance. They use a different system wherein the first 30 minutes are billed, and then each additional 15 minutes is billed as a separate code, so there may be several line items. Your case sounds like a 75-minute case in which you would be billed 10 units. Again, without seeing any of this it is hard to know, but I suspect this was the case.
Steven I Ganzberg, SB, DMD, MS
Formerly, Clinical Professor of Dentistry
College of Dentistry
The Ohio State University