Anesthesia Service Line Units Need To Defer To 1 Unit EDI Transactions, TR 29962

June 4, 2013

Providers who are submitting professional claims for anesthesia services via Direct Data Entry (DDE) will notice a change in how the minutes are displayed. The DDE screen will display the total number of minutes entered (in the minutes field, located next to the units field), and the number of units in the Claim Total box. All units now default to 1 instead of 0. During claim pricing, the correct units will be calculated and paid appropriately. 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.