Anesthesia Claims FAQs

If you set different anesthesia options in the Fee Schedule and Code, which one will take precedence?

If a Fee Schedule is applicable, then the settings from that Fee Schedule will be used (similar to how the Default Price works).

When would a user set it in both places and why?

There are times when a Fee Schedule might not be active, or a code might not be included in the Fee Schedule (also similar to how the Default Price works).

If the user chooses to "Use anesthesia base units from MPFS" where/how can they see what the value is for the MPFS base unit?

Code > Fee Schedule > View MPFS > RVUS tab > Units

If I select to use the MPFS option (on either code or fee schedule). I look at the RVU displayed = 0. When entering my code on my claim I set my anesthesia start/end time to 15 mins (which by default is the # per minutes set). Should I see 0 units (Since that's what is in the RVU) Or 1 unit since 15 mins = 1 unit?

In this instance, you should see 1.  Because we perform the following calculation: units = baseUnits + (anesthesiaMinutes / minutesPerUnit)So, the base units from the MPFS = 0, and then 15 / 15 = 1  

Why can't I set/override (anesthesiaMinutes / minutesPerUnit) in codes like I can in Fee schedule?

This wouldn't align with the intent of the feature. The "minutes per unit" value is defined by the payer - in theory, that should be a payer-specific setting, but since this value is so closely tied to the price it makes more sense to configure this with the pricing - IE the fee schedules.This further aligns with how our system uses the data - we ONLY use the units to calculate the default price on the claim. When the claim is actually sent, we send the minutes value.