Anesthesia

1. Anesthesia provided in the dental office must be billed on the 837D claim form with ADA CDT procedure codes.
2. Anesthesia provided in an ASC/hospital must be billed on the 837P claim form by the anesthesia group.
3. PrimeWest Health-enrolled Certified Registered Nurse Anesthetists (CRNAs) or anesthesiologists must bill separately for their anesthesia services on the 837P claim form with CPT procedure codes or American Society of Anesthesiologists (ASA) anesthesia codes with the appropriate modifiers.
4. Hospitals must bill anesthesia services when the CRNA or anesthesiologist is a hospital employee unless the hospital chose to remove CRNA costs from its inpatient rate.

Anesthesia and Facility Fees in an Outpatient Hospital or Ambulatory Surgery Center (ASC) Setting

Anesthesia for dental cleaning and restorations is a covered service for PrimeWest Health members when provided in an outpatient hospital or ASC setting (location codes 19, 22, or 24) and when providers bill using CPT code 00170 along with CPT code 41899 on the same day. An authorization is required for CPT code 41899 when used for any other dental service.

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Updated_11/01/2018