This version of the policy will become effective 04/21/2020. The following criteria have been added to the policy:
ANESTHESIA SERVICES PERFORMED BY ANESTHESIA PROVIDERS
Anesthesia services (including Monitored Anesthesia Care [MAC]) performed by an anesthesia provider (i.e., anesthesiologist, certified registered nurse anesthetist [CRNA]), in conjunction with a medically necessary procedure(s) or service(s), are covered and eligible for reimbursement consideration by the Company when the services are reported in accordance with this policy and the appropriate documentation is included on the claim and the individual's medical record.
Medical direction by an anesthesiologist is covered and eligible for reimbursement consideration by the Company when all the following requirements are met:
99100, 99116, 99135, 99140
99151, 99152, 99153, 99155, 99156, 99157
A MODIFIER FROM THE FOLLOWING LIST IS REQUIRED TO BE REPORTED WHEN REPORTING ANY ANESTHESIA PROCEDURE CODE LISTED IN ATTACHMENT A:
PERFORMANCE VERIFICATION MODIFIERS