The following types of anesthesia qualify for payment as anesthesia services:

1. Inhalation
   
   
2. Regional
   
   1. Spinal (low spinal, saddle block)
   2. Epidural (caudal)
   3. Nerve block (retrobulbar, brachial plexus block, etc.)
   4. Field block
   
   
3. Intravenous
   
   
4. Rectal
   
   
5. Conscious sedation
   

In addition, anesthesia for diagnostic or therapeutic nerve blocks and injections (01991, 01992)(when the block or injection is performed by a different provider) is eligible for payment.

Local anesthesia (A9270), which is direct infiltration of the incision, wound, or lesion is not a covered service.

Payment for anesthesia services is evaluated through the use of relative values. Basic unit values have been assigned to most procedures and reflect the difficulty of the anesthesia services including the usual pre-operative and post-operative care and evaluation. When anesthesia is reported, the service should be reported processed under the appropriate CPT anesthesia procedure code. In addition, when a surgical procedure is reported for which no base units have been assigned, a minimum of three base units will be assigned to the anesthesia service.

Payment for anesthesia services is evaluated according to the basic unit value, plus time units reported, plus eligible modifying units when appropriate, multiplied by a monetary conversion factor. (See Medical Policy Bulletin A-11 for additional information on modifying units and procedure codes.)

The basic value for anesthesia when multiple surgical procedures are performed is the basic value for the procedure with the highest unit value. No payment is allowed for the basic unit value of a second, third, etc., procedure.

Anesthesia time begins when the anesthesiologist is first in attendance with the patient for the purpose of creating the anesthetic state, and ends when he is no longer in personal attendance (that is, when the patient may be safely placed under the customary post-operative supervision). This time must be documented on the anesthesia record.

When calculating time units for the time actually spent administering anesthesia, each fifteen (15) minute segment or fraction thereof should be considered one time unit.

Local anesthesia (01991, 01992, J0670, J2001, J2795, S0020) is covered.