We have revised the unit calculation to meet insurance standards. The formula for calculating and billing anesthesia codes is as follows:
Total Units = Base Units + Timed Units + Physical Status Modifier Units
Please ensure that your fee schedule(s) list the correct pricing or anesthesia codes.
Definitions
Base Units—The Centers for Medicare and Medicaid Services (CMS) assigns base units for each anesthesia procedure code. These base units are loaded into DrChrono and will apply automatically based on the anesthesia code entered.
Timed Units - Anesthesia time / 15, rounded
Physical Status Modifier Units -
P1 A normal healthy patient - 0 units
P2 A patient with mild systemic disease - 0 units
P3 A patient with severe systemic disease - 1 unit
P4 A patient with severe systemic disease that is a constant threat to life - 2 units
P5 A moribund patient who is not expected to survive without the operation - 3 units
P6 A declared brain-dead patient whose organs are being removed for donor purposes - 0 units
Utilizing in a patient's appointment
We have added the formula as an information icon in the Billing Detail screen. To see it,
- Navigate to Billing > Live Claims Feed
- Pull up the patient by name, date of service, or drc claim #.
- Press the blue date of service to enter the billing details screen.
- When an anesthesia code is entered, the information icon will appear.
