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Billing for your CRNA Rendered Services
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Billing for a your CRNA services is not difficult. But it is very important that you
know how to read an operative report and of course the anesthesia record. The
H&P on the medical record can also guide you for its medical necessity based on
the history, physical and current condition of the patient.

There are guidelines and rules that also needs to be followed (depending on the
state where the CRNA professional is practicing).

Make sure you code and bill based on the documentations!

The CMS Processing Manual is one very useful publication from Medicare for you
to be guided on how to bill properly for these services. You will also have an idea
how these claims are processed and reimbursed.

The CRNA Services starts on Section 140 of this Manual.

Chapter 12 of CMS Claims Processing Manual for Physicians and Non-
Physicians Practitioners

For CRNA Services - see section 140
For CRNA Fee Schedule Payment - see section 140.3
For Billing Modifiers - see section 140.3.3
How Anesthesia Time and Anesthesia Time Units are calculated - see
section
140.3.2

Here are your anesthesia services relevant modifiers:

• QX
- CRNA with medical direction by a physician.  
• QZ - CRNA without medical direction by a physician.  
• QS - Monitored anesthesiology care services (can be billed by a CRNA or a
physician).  
• QY - Medical direction of one CRNA by an anesthesiologist.  This modifier is
effective for anesthesia services furnished by a CRNA (or AA) on or after January
1, 1998.

General Billing Instructions for CRNA Services - see section 140.3.4

When a CRNA and Anesthesiologist Work Together - see section 140.4.1

When a CRNA and Anesthesiologist in a Singe Procedure - see section
140.4.2

Reference: CMS Chapter 12 Claims Processing Manual for Physicians and Non-
Physician Practitioners ((Rev. 2373, 12-21-11))

Related Reference: CMS Chapter 15 - Medicare Benefit Policy Manual on
Covered Medical ad Other Health Services (Rev. 157, 06-08-12)

Website:
www.cms.gov