Because anesthesia reflects actions in the operating room, anesthesia billing involves nearly all of the 13,000-plus procedure codes. Most of the billing errors that cause anesthesia under/over-billing stem from two inherent characteristics not found in other specialties:īilling for most specialties involves a limited number of relevant CPT code sets – for example, perhaps 10 to 15 codes in obstetrics – with which coders become highly familiar. Sources of Anesthesia Reimbursement Shortfalls When integration includes certified registered nurse anesthetists (CRNAs) and/or anesthesiologists, specific steps must be taken to avoid reimbursement shortfalls and unexpected compliance issues that are often detected during routine audits. That’s often not the case with anesthesiology, which has unique characteristics that require special skill sets that typically don’t exist in a CBO. Hospitals and health systems implementing physician integration strategies tend to assume that their central billing offices (CBOs) have them covered for billing, coding and compliance issues. Incorrect billing often leads to under-billing and risk of compliance action. Incorrect hospital billing for anesthesia
