Hello. I am fresh out of residency and have joined the ranks of private practice. When I was in residency, I was under the impression that we could bill more for patients who have higher ASA classification status, as well as billing for for IV placement and prone position/field avoidance? My groups billing form does not have these things. Anyone know about these things??????
IV placement is considered part of the global anesthesia fee and is generally not reimbursable as a separate item, although you could make a case for an IV start on a patient on the floor that no one else has been able to get (could be billed as an IV placement, or some might bill as an anesthesia consult). Also - since your anesthesia start time is usually when you enter the OR, if you start the IV in the OR (rather than in the holding area) that time should be legitimately billable.
Medicare generally pays for almost no modifiers, and many insurors have followed suit. Especially for Medicare, most patients are old and sick, so they reason they won't pay extra for it. ASA status, extremes of age, position other than supine or lithotomy, etc., are frequently ignored, but depends totally on who's paying the bill. That's the key - what is reimbursed and what is not, how much is billed, and how much can be balance billed to the patient, is often a function of your provider contracts (if you have one). If there is no contractual agreement, full charges can apply with balance billing to the patient after insurance pays whatever they decide to pay.
Trivia for the day - ASA 1 and 2 = 0 RVU's. ASA 3 = 1, ASA 4 = 2, ASA 5 = 4.
How much is an ASA 6? ZERO. I have been told that ASA 6 was created because many years ago, some groups would call organ harvest patients ASA 5 (along with other modifiers) and pad the bill to the organ procurement agency.
