Anesthesia Units to Follow Primary Claim

The Anesthesia Units to Follow Primary Claim option in Practice Preferences > Claims controls whether secondary and tertiary claims are submitted with the same total anesthesia units that are submitted on primary claims.

When this check box is selected, the total anesthesia units calculated for the primary payer are used on claims for all COBs.

When this check box is not selected, the total anesthesia units may be different on claims for each COB based on payer-level settings.

The total anesthesia units for a charge are normally recalculated when a claim is created for each payer on the encounter; primary, secondary and tertiary. The following calculation is used:

[Base Units + Time Units + Modifier Units = Total Units]

Base Units are defined for the SIM code in the Services Items library and are not payer specific. Therefore, base units are the same for all payers.

Time Units are calculated based on the Anesthesia Minutes Per Unit and Anesthesia Rounding Method defined for each payer in the Payers master file. Because these are payer-level settings, time units may be different for each payer.

Modifier Units are defined in the Claim Modifiers library. Because each payer may have a different library attached, modifier units may be different for each payer.

The total units on the primary and secondary claims is determined by the Anesthesia Units to Follow Primary Claim setting.