Anesthesia Module
The GoRev Anesthesia module allows for ASA crosswalk enabled anesthesia coding and billing for CRNA, Assistants, and Anesthesiologists. Here are some great external resources related to Anesthesia billing and coding.
https://www.cms.gov/Center/Provider-Type/Anesthesiologists-Center
Anesthesia Module Administration
1: Enable Anesthesia Roles in the Physician Directory
Create records for your anesthesia personnel by following this guide: Adding a Physician. From there you can activate an anesthesia role by referring to the below.
There are three anesthesia related roles; Anesthesiologist, Assistant, and CRNA.
Navigate to the Admin tab in GoRev and then click Physicians. Create a physician record for this user. Double click back into the physician and you will see a drop down titled Anesthesia Role. Apply the appropriate role and click save.
2: Create Chargemaster items for Anesthesia codes
Creating charge master items for anesthesia billing follows the same process as any normal charge master item creation found here: Charge Master. Anesthesia is billed based upon a base unit and minutes based calculation. You will need to be knowledgeable in this in order to set an appropriate per unit rate.
There is one unique charge master feature specific to anesthesia; Anesthesia Flat Rate checkbox. When this checkbox is activated the anesthesia billing system will use the price specified regardless of number of units calculated.
3: Configure Payer Specific settings
The GoRev Anesthesia module supports % of charges claim splitting. These settings are configured at a carrier level (see carrier administration guide here: Insurance Carrier Management)
Click on the Claim Generation tab and configure the settings shown below. The percentage values you enter will be applied against the total calculated charges in order to calculate the total charges to use on the split claim for each provider type.
4: Load your ASA crosswalk (optional)
You can always use an ASA crosswalk book or other manual tools to locate the appropriate anesthesia code. GoRev supports loading of a digital ASA code set and when loaded allows you to use instant search drop downs within the Anesthesia user interfaces.
This ASA crosswalk is licensed to each individual user (we do not license this for you). You are responsible for obtaining appropriate licensing and utilizing the digital crosswalk within the constraints of your license. See here for resources on how to license and obtain an ASA crosswalk digital file.
To load the ASA crosswalk into GoRev:https://www.asahq.org/shop-asa/mkcw2021b10. Click the Read More and look for these details:
Click on your name towards to the right. Click into the Coding Tab. Click the Import Crosswalk button. Select the crosswalk file on your computer. The crosswalk is now loaded for your username (it is user specific and each individual user who has a valid ASA crosswalk license and data set will need to perform this process)
Anesthesia Module Use
The Anesthesia module can be accessed by clicking the Anesthesia button from Patient Overview:
Or the Anesthesia button within the Coding window:
Once clicked the main Anesthesia UI opens as shown below. See further down for details regarding each section.
Step 1: Set your Services up and specify Anesthesia details
Each procedure you need to code anesthesia services on will need its own service. Click the + symbol to add additional services.
Anesthesia Type does not impact modifiers or coding. This is for your reporting/tracking purposes. These types are configured within the Anesthesia Type lookup table (see here for guide on look up lists: Lookup Tables). The most commonly used list of Anesthesia Types is:
Block
Block-Bier
General
Local
Local with Standby
MAC
TIVA
Step 2: Specify Patient Physical Status
This field impacts assignment of Physical status modifiers:
Simply add a "P" to the number in the list below and this is the modifier that will be applied to the Anesthesia code selected.
Step 3: Specify Situational options
Checking the Medically Directed checkbox will apply the QS modifier indicating Monitored Anesthesia Care (MAC) services (can be billed by a qualified nonphysician anesthetist or physician)
Checking the Severe cardio-pulmonary history checkbox will apply the G8 modifier indicating Deep complex complicated, or markedly invasive surgical procedures
Checking the Invasive surgical procedure checkbox will apply the G9 modifier indicating the patient has a history of a severe cardiopulmonary condition
Step 4: Specify providers and procedure time
Click into the Provider box and instant search to find each provider of anesthesia services for this specific procedure. Specify the start and stop time of this specific procedure. If the provider is supervising check the supervising box (applies the PD modifier). Once done click Add. Repeat this process for any additional providers. Keep in mind, Provider type also drives selection of modifiers. This is setup on each physician record (see process in Administration section above)
It will look like this after you have added a provider:
Step 5: Specify Time and Modifier Overrides
The system will attempt to select appropriate modifiers based upon your entries however it is your responsibility to ensure accurate coding is applied to an account. WIth this in mind, we provide you with the opportunity override time and modifiers in these two sections below:
Step 6: Specify surgical procedure and select Anetshesia code
If you have loaded your ASA crosswalk the boxes below will allow you to instant search by surgical procedure code and find the related anesthesia code within the crosswalk. For example, if you type in 63685 you will see two options for anesthesia codes related to this procedure. Select the accurate one for your case and double click or press enter on it.
Click Add and the system will calculate minutes and units based on the code selected and time specified previously. If you do not have a crosswalk you can manually specify any of these fields. They system will automatically attempt to select the most related charge code from your charge master. You can override this by clicking into the Charge Code drop down and instant searching for alternative charge master items. Once you are ready, click Finalize/Charge checkbox.
Repeat this process for any additional services (click the + to open up a new service). Once done click the Save All button towards the top right. This will apply all modifiers and charges to the account.
GoRev Support Team
If you have any questions, concerns, or problems regarding this GoRev Tutorial, please contact the GoRev Support Team by submitting an IT Support Ticket, by phone at 1-(317)-794-3900, and/or by email at ask@gorev.com.
Note: Always submit an IT Support Ticket detailing the problem that you are experiencing with this portion of GoRev, if possible, as this will give GoRev Support Agents access to information that will help expedite the resolution of your issue. If you are unsure how to submit an IT Support Ticket in GoRev, please see the IT Support Ticket Creation tutorial for assistance.