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Anesthesiology Charge Amount Calculation

The Charge Amount will be calculated by multiplying the Anes Conv Factor times total of Base Units, Time Units, and Modifier Units. If the Provider <Anes Time Unit Calc> is left blank – Intellect will use the Procedure <Charge Global> fee.

For example:

1: Time Units are calculated as follows:  The Provider <Anes Time Unit Calc> field entry is 15 (i.e., 15 minutes per unit) and the Charge <Time> and <To> field entries are 8:00am and 9:30am. Divide the total posted time, 90 minutes (8:00a to 9:30a), by the <Anes Time Unit Calc> of 15, equaling 6 Time Units.

2: Total Units are calculated as follows. Add the Time Units (Example 1), the Procedure Units (the Procedure <Anes Base Unit 1 (or 2, 3)> field entry: determined by the Insurance <Selection (1/2/3)> field entry), and any Modifier Units if applicable, (the Modifier <Base Unit> field entry).

3: The Charge Amount is calculated as follows:  Multiply the Total Units (Example 2), by the Provider <Anes Conv Factor 1 (2, or 3)> field entry: determined by the Insurance <Selection (1/2/3)> field entry.

Information will display as follows on the CMS 1500 Claim Form (HCFA):

Private Carriers  (Insurance <Insurance Type> other than C, 1 or D):

Box 24 G Intellect will complete the total posted time in minutes. For example, posting the start time of 8:00am to the ending time of 9:30am would enter '90'

                                    (90 minutes) in Box 24G.

Box 24 A

through 24 F Intellect will complete the following directly below each charge:

                                    Start time 00 00 End 00 00 Total Units 0

                                     (For example:  Start time 08 00 End 09 30 Total Units 9)

Medicare and             (Insurance <Insurance Type> C and 1)

Medi-Medi              Intellect will complete the total posted time in minutes. For example, Box 24G posting the start time of 8:00am to the ending time of 9:30am would  enter '90' in Box 24G

NOTE: Per Medicare: the Starting Time, Ending Time and Total Units are not required

on the claim.

Medi-Cal                   (Insurance <Insurance Type> D)

Box 19 Intellect will complete the following:

                                    Start time 00 00 End 00 00 Total Time 0000

                                    (For example:  Start time 08 00 End 09 30 Total Time   90)

Box 24G Intellect will complete the total posted Time Units.