Date: September 29, 2021
To: Enrolled Physicians; Advanced Practice Registered Nurses; and Hospitals (Chief Executive Officers, Chief Financial Officers, and Patient Accounts Managers)
Re: Change in Billing for Anesthesia Effective with Claims Received on and after October 1, 2021
This notice informs anesthesiologists and certified registered nurse anesthetists (CRNAs) of a change in billing policy for professional anesthesia services. This change applies to claims billed under both the Department's fee-for-service program and the HealthChoice Illinois managed care plan programs.
Past policy allowed providers to utilize either the surgical CPT procedure code or the anesthesia code when billing for anesthesia units. Effective October 1, 2021, regardless of date of service, providers must use the appropriate anesthesia code in the CPT code range 00100 through 01999 to bill for the anesthesia units.
Claims received on and after October 1, 2021 that are billed with the surgical procedure code instead of the anesthesia procedure code will be rejected with error code N41 - Review Anesthesia Service Documentation.
Questions regarding this notice may be directed to a billing consultant in the Bureau of Professional and Ancillary Services at 877-782-5565 or the applicable managed care plan.
Kelly Cunningham, Administrator
Division of Medical Programs