You work at an eye center doing cataracts. It's just you in one room and a CRNA in the room next door. You are available to consult by the CRNA as necessary throughout the day. Your case times overlap. Can you claim direction, supervision or neither?
Supervision Question
- Thread starter Outrigger
- Start date
It's non medically directly. You can't bill for "supervision". You are what's in a "collaborative anesthesia practice"
Unless you are billing for your own cases, someone is making a whole lot of money off of you and the crna in the other room.
Unless you are billing for your own cases, someone is making a whole lot of money off of you and the crna in the other room.
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Your 'consult' ability is likely facility policy and probably needs to be looked at. Your best option is likely to bill the modifier AA for the MD solo and QZ for the CRNA solo.
Moving on from the billing regarding the consult you are either involved or not so you need to have this clearly laid out. Mixed practices like this are out there obviously, but you need to be careful as to what kind of decisions you are making and in what capacity. Your policy should state that the CRNA is acting as a solo independent practitioner. The surgeon signs off on the anesthetic if needed per CMS and opt out states. Any consult rendered would be in a non supervisory role. Here's where it gets really sticky. If the CRNA is relying on your advice to make a diagnosis or select a treatment, you are participating in the patients care. There is now an implied physician-patient relationship and you are fair game for malpractice.
Moving on from the billing regarding the consult you are either involved or not so you need to have this clearly laid out. Mixed practices like this are out there obviously, but you need to be careful as to what kind of decisions you are making and in what capacity. Your policy should state that the CRNA is acting as a solo independent practitioner. The surgeon signs off on the anesthetic if needed per CMS and opt out states. Any consult rendered would be in a non supervisory role. Here's where it gets really sticky. If the CRNA is relying on your advice to make a diagnosis or select a treatment, you are participating in the patients care. There is now an implied physician-patient relationship and you are fair game for malpractice.
