Moderate (Conscious) Sedation

Moderate (Conscious) Sedation Moderate sedation codes 99143‒99150 were deleted and replaced with codes 99151‒99157 in 2017. 99151‒99157: Are not used to report administration of medications for pain control, minimal sedation, deep sedation, [...]

National Coverage Determinations

National Coverage Determinations General Medicare coverage is limited to items and services that are reasonable and necessary for the diagnosis or treatment of an illness or injury (and within the scope of a Medicare benefit category). NCDs [...]

Teaching Anesthesiology Services

Teaching Anesthesiology Services Table of Contents Teaching Anesthesiology Services Anesthesia Services and Teaching CRNA Physician Personally Performed and Personally Performed with CRNA and AA Related Content [Return to Top] [...]

Resources and References

Resources and References Anesthesia Guidelines and Regulations CMS IOM Publication 100-04, Medicare Claims Processing Manual, Chapter 12 Section 50 CMS IOM Publication 100-08, Medicare Program Integrity Manual, Chapter 10 CMS [...]

Anesthesia Billing Codes

Anesthesia Billing Codes Table of Contents Anesthesia Not Otherwise Classified Codes Add-On Codes for Anesthesia Related Content [Return to Top] Anesthesia Body Area CPT Codes Head 00100‒00222 [...]

Daily Management and Pain Management

Daily Management and Pain Management Table of Contents Daily Management of Continuous Pain Control Techniques Pain Management Consultations Postoperative Pain Control Procedures [Return to Top] Daily Management of Continuous [...]

Monitoring Anesthesia Services

Monitoring Anesthesia Services Monitored Anesthesia Monitored anesthesia care involves intraoperative monitoring by a physician or qualified individual under the medical direction of a physician or of the patient’s vital physiological signs [...]

Payment and Reimbursement

Payment and Reimbursement Table of Contents Anesthesia Claim Billing Instructions Multiple Anesthesia Procedures Multiple CRNAs Same Procedure Payment at Personally Performed Rate Payment at Medically Directed Rate Payment at [...]

Provider Qualifications

Provider Qualifications Table of Contents General State Licensing Physician – Anesthesiologist (Specialty 05) Medical and Surgical Services Performed with Anesthesia by an Anesthesiologist Qualified Nonphysician Anesthetists [...]

National Government Services Guide for New Providers

National Government Services Guide for New Providers

National Government Services Guide for New Providers

National Government Services Guide for New Providers

A/B DME MAC Collaborative Lower Limb Orthoses Webinar

A/B DME MAC Collaborative Lower Limb Orthoses Webinar This is your opportunity to hear directly from the Medicare contractors regarding Medicare’s criteria necessary for the coverage of lower limb orthoses. Representatives from all four DME [...]

Cervical Fusion with Disc Removal Best Practices

Cervical Fusion with Disc Removal Best Practices Table of Contents Introduction Coverage General Documentation Requirements Medical Necessity Criteria for Each Indication Limitations and Exceptions to Conservative Therapy [Return to [...]

Home Health Billing

Avoiding Reason Code 38200

CR 9189 Transmittal 602: Medical Review of Home Health Services

Contractor Advisory Committee

Assist National Government Services in the Development of Local Coverage Determinations Background CMS released Change Request 10901 and the companion MLN® Matters MM10901: Local Coverage Determinations (LCDs) article to expand the parameters [...]

Appeals/Reopenings

Medicare Part B 101 Manual Appeals/Reopenings Table of contents Reopenings for Minor Errors and Omissions Telephone Reopening Unit Appeals Time Limit for Filing Appointment of Representative Redeterminations Acceptable Signature [...]