Anesthesia Claims Submission Reminder

January 2, 2013

Anesthesia Claims Submission Reminder

When submitting claims for anesthesia minutes using the ANSI 837 electronic claim format, element SV103 cannot be left blank. These claims must contain a value of ‘MJ’ qualifier (minutes) with the number of minutes residing in SV104. The minutes should be submitted as whole numbers (1 through 9999). Claims that do not contain a value in SV103 will result in an overpayment.

Effective 12/12/12, claims that do not contain the “MJ” qualifier in SV103 for procedure codes ranging from 00100-01999 will be rejected.

Providers can also report anesthesia minutes for professional claim submissions via Direct Data Entry (DDE). The DDE screen will display the total number of minutes entered (field located next to the units field) as well as the number of units, in the claim total box. During pricing calculations, the minutes are converted to units (15 minutes = 1 unit). If the result includes a decimal of .5 or greater, the number of units is rounded up. If the result includes a decimal less than .5, the number of units is rounded down. The converted units are used when pricing the claim.

Claims and claims adjustments can be submitted using either the DDE Portal or the ANSI 837 electronic claim format.

Paper claims can NOT be used to submit anesthesia claims at this time. We are currently working on a resolution to this issue and will notify you when paper claims can be submitted.

Providers can contact Provider Services at 1-866-690-5585 with questions.