Anesthesia Concurrency Billing for OB

Help Guide for NextGen® Enterprise PM 8

Anesthesia Concurrency Billing

Anesthesia Concurrency Billing in NextGen® Enterprise PM can be setup and used by practices that must meet specific requirements on professional claims for anesthesia services that occur at the same time, or concurrently. Concurrency billing is typically used when the practice submits 837P/1500 claims for numerous anesthesia procedures that are administered in a hospital surgery department setting by Anesthesiologists and medically directed Certified Registered Nurse Anesthetists (CRNA). An Anesthesiologist can personally administer anesthesia to a patient. They can also oversee the administration of anesthesia by Certified Registered Nurse Anesthetists (CRNA) and Anesthesiologist Assistants (AA). When an anesthesiologist oversees up to four concurrent cases, it is considered "medical direction". In NextGen® Enterprise PM, an Anesthesia Concurrency Audit process is run prior to billing and creating claims. The audit looks at encounters with charges that were rendered by anesthesia prov

Help Guide for NextGen® Enterprise PM 8

Charge Posting for Anesthesia Billing

Once you have setup your practice to support anesthesia billing by completing the setup for anesthesia concurrency billing, and defined your claim rules and SIM pricing options in File Maintenance for anesthesia, you need to select a default practice-level Anesthesia Library and set up an ASA Crosswalk library to activate the crosswalk file on the Charge Posting window before entering charges for anesthesia services. Enter Anesthesia Charges You can enter anesthesia charges on the Charge Posting window. Anesthesia Service Information Window Parent topic: Anesthesia Concurrency Billing

Help Guide for NextGen® Enterprise PM 8

OB Epidural Billing

The American Society of Anesthesiologists Relative Value Guide lists the following methods as examples to determine professional charges for billing labor anesthesia services: Base units plus time reporting in minutes (insertion through delivery) subject to a reasonable cap. Base units plus one unit per hour for neuraxial anesthesia service management plus direct patient contact time, commonly referred to as Face Time. Incremental time-based fees (e.g. 0<2 hrs, 2-6 hrs, >6 hrs) Single or flat fee Since practices determine their own method for billing OB anesthesia services, NextGen® Enterprise PM can accommodate commonly used and known methods of billing OB anesthesia services. These include: Pain Management epidurals should not be counted against maximum concurrency. Billing for labor cases that changed from a planned vaginal delivery to an emergency C-section. This is the only time billing two anesthesia codes on a claim is permitted. Some payers recognize only time in attendance wit

File Maintenance Help for NextGen® Enterprise 8

Anesthesia Library Reports

The following Anesthesia Library reports can be generated from File Maintenance. The Report columns display information related to specific areas of setup for each library. Anesthesia Library Listing: This report includes information defined in the top section of the Anesthesia Library Maintenance window. Anesthesia with Payer Detail: This report includes information defined on the Anesthesia Library Payer Maintenance window for the Medical Direction, Concurrency Rules, and Claim Options tabs. Anesthesia with SIM Options: This report includes information defined on the Anesthesia Library Payer Maintenance window for the SIM Options tab. Generate an Anesthesia Library Report Parent topic: File Maintenance Library Reports

Help Guide for NextGen® Enterprise PM 8

Set Up SIM Options for OB Anesthesia Billing

To accommodate OB epidural billing needs, the Anesthesia Library > SIM Options tab includes a number of settings that may be helpful. Access File Maintenance. Select Libraries, and then Anesthesia. The Anesthesia Library List window opens. Double-click to open the desired library. The Anesthesia Library Maintenance window opens. In the Concurrency and Claim Rules section, do one of the following: To create a new rule, select the Open Menu button and select New. The Anesthesia Library Payer Maintenance window opens. For more information, see Set Up Concurrency and Claim Rules for Anesthesia Billing To modify an existing rule, select the row from the list, select the Open Menu button and select Open. The Anesthesia Library Payer Maintenance window opens. Select the SIM Options tab. In the Service Items Range Options section, do one of the following: To create a new SIM range, select the Open Menu button and select New. The SIM Range window opens. For more information, see Set Up SIM Opti

Help Guide for NextGen® Enterprise PM 8

Practice Preferences Options for Anesthesia Billing

Whether using Basic Anesthesia Billing or Anesthesia Concurrency Billing in NextGen® Enterprise PM, the following anesthesia-related options are available in Practice Preferences: Single Base Unit Anesthesia Charge per Encounter Anesthesia Units to Follow Primary Claim In Progress Billing Status Single Base Unit Anesthesia Charge per Encounter Anesthesia Units to Follow Primary Claim In Progress Billing Status Parent topic: Setting Up Basic Anesthesia Billing

Anesthesia Concurrency Billing for OB

Recommendations

Anesthesia Concurrency Billing

Charge Posting for Anesthesia Billing

OB Epidural Billing

Anesthesia Library Reports

Set Up SIM Options for OB Anesthesia Billing

Practice Preferences Options for Anesthesia Billing

Anesthesia Concurrency Billing

Charge Posting for Anesthesia Billing

OB Epidural Billing

Anesthesia Library Reports

Set Up SIM Options for OB Anesthesia Billing

Practice Preferences Options for Anesthesia Billing