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CRNA under medical direction

K Posted Wed 04th of February, 2015 13:15:21 PM

Hello,
I have a few questions about billing for CRNA services with medical direction. First, is medical direction and supervising the same?

I understand how to use the status indicators for the claim and modifier QZ, and QS. If CRNA is not credentialed, and is being medically directed, how would you use the modifiers AA, QX, and QY? Would you be able to give me a example? Do you only bill under the directing MD or do you bill under both the CRNA and directing MD?

I know we will need to have both signatures on the documentation. Can the supervising provider just sign it or should it list "supervising MD or Medical Directing MD" under their signature on the dictated anesthesia report? Would that be enough to document that the case was under medical direction or should you have the physician who was directing the case sign the anesthesia flow sheet? Would that need a note that they were directing or is just a signature under the CRNAs name sufficient?

How long can you bill under the anesthesiologist NPI number with out credentialing the CRNA with Medicare or other companies that credential CRNAs?

If the insurance plan does not cover the use of a CRNA, have you found they pay for a medically directed case or will we either need to have a ABN signed or have a MD perform the anesthesia on the case in order to have the claim reimbursed?

SuperCoder Answered Thu 05th of February, 2015 06:39:40 AM

You have posted multiple questions in one post. Please break the questions and post them in individual post. Thanks !!

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