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Obamacare, You're Fired - December 2016 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Ever Wonder How Anesthesia Gets Paid? A crash course in base units and 15-minute increments of time. E ver wonder how anesthe- sia providers are paid? Most of us are salaried or are paid hourly, but it's good for facility man- agers to know how the folks at the head of the table bill insur- ers for our services — and what factors make a facility a desirable place for us to work. Let's start with how anesthesia is billed: in base units and time units. • Base units. These are the numeric value attached to each CPT code. They cover the pre-operative interview, and generally factor in complexity and risk. Anesthesia for a laparoscopic cholecystectomy is valued at only 7 base units, while a coronary artery graft without car- diopulmonary bypass is valued at 25 base units. • Time units. These are generally in 15-minute increments. They start the moment a provider enters the OR and stop the moment he gives a report to the PACU nurse. There are some exceptions, but generally, if a case has 6 base units and takes 60 minutes, you'd bill for a total of 10 units (6 base + 4 time). The ASA Relative Value Guide lists the number of base units for each case. Check the area of the body having the procedure and look under the list of codes. For example, cataract surgery falls under "pro- cedures on the eye" and 00142 is anesthesia for lens surgery (4 base units plus time units). 1 2 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • D E C E M B E R 2 0 1 6 Anesthesia Alert Mike MacKinnon, MSN, FNP-C, CRNA • MEDICAL ECONOMICS Do you understand how anesthesia is billed?

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