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Determining Anesthesia Service Payments and Modifiers As a new medical coder for an Anesthesiologist group, it is important that you practice calculating service payments by assigning the appropriate
Determining Anesthesia Service Payments and Modifiers
As a new medical coder for an Anesthesiologist group, it is important that you practice calculating service payments by assigning the appropriate anesthesia code(s) and modifier(s), as well as determining the base and time unit values, any modifying circumstances, and the conversion factor to arrive at your anesthesia service payment.
Apply your knowledge of Anesthesia coding.
Include the following aspects in the assignment:
Ø Use the data in the tables below
Ø Be creative and create two different scenarios
Ø Time should be in 15 minute increments
Ø Describe how to calculate anesthesia base and time units
Ø Distinguish anesthesia service payments by using and describing the approved formula
Ø Arrive at the correct reimbursement and coding responses for each scenario
Ø Assign physical status and qualifying circumstance codes to your CPT anesthesia codes in each of the two scenarios.
Physical Status Modifiers
Physical Status Modifiers Relative Value
P1 0
P2 0
P3 1
P4 2
P5 3
Qualifying Circumstances
Qualifying Circumstances Code Relative Value
99100 1
99116 5
99135 5
99140 2
Conversion Factors by Location
Locality Name National Anes CF of 22.2730
ALABAMA 21.20
ALASKA** 30.99
ARIZONA 21.95
ARKANSAS 21.25
BAKERSFIELD, CA 22.36
CHICO, CA 22.29
EL CENTRO, CA 22.30
FRESNO, CA 22.29
HANFORD-CORCORAN, CA 22.30
Anesthesia Base Units by Anesthesia CPT Codes
CODE BASE UNITS CODE BASE UNITS
00100 5 00539 18
00102 6 00540 12
00103 5 00600 10
00104 4 00620 10
00120 5 00625 13
00210 11 01960 5
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