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  • Anesthesiology Coding Specialists

Anesthesiology Medical Billing Services

Anesthesia billing isn’t a straightforward procedure coding. It’s time-based calculations, ASA base units, modifier combinations, and physical status modifiers that general billers systematically miscalculate.

One wrong time calculation, one missing qualifying circumstance, or one incorrect physical status modifier—and $30K-$70K vanishes monthly.

Neo MD fixes that with anesthesiology-certified coders, precise time tracking protocols, and modifier-compliant billing workflows.

95-97%

First-Pass Claim Acceptance

+28%

Average Revenue Increase

90

Days to Results

Get Free Anesthesiology Revenue Analysis
Talk to an Anesthesiology Billing Expert
  • Practice Revenue Health Audit

Is Your Anesthesiology Practice
Bleeding Revenue? (Most Are.)

If any of these are happening, you’re losing $360k-$840k  annually:

Visible Revenue Bleed

Immediate Impact

Priority: Critical
Audit Code: ANS-901

Anesthesia Time Calculated Incorrectly

Start/stop times are rounded wrong, missing incremental units

Priority: High
Audit Code: ANS-902

Physical Status Modifiers Missing

P3, P4, P5 modifiers not applied = lost reimbursement

Priority: High
Audit Code: ANS-903

Qualifying Circumstances Uncaptured

99100, 99116, 99135, 99140 add-ons never billed

Priority: Critical
Audit Code: ANS-904

Medical Direction vs Supervision Confusion

QK, QX, QY, QZ modifiers applied incorrectly

Priority: High
Audit Code: ANS-905

ASA Base Units Wrong

Incorrect CPT code selection = wrong base unit calculation

Priority: Medium
Audit Code: ENT-906

Bilateral Procedure Modifier Missing

Not applying modifier 50 on bilateral surgeries

Invisible Losses

According to ASA and industry data, anesthesiology practices lose 26%–38% of revenue due to:

Time Calculation Errors

Minutes to units conversion

18% underpayment

Physical Status Modifiers

P3-P5 never applied

$12K-$28K/month

Qualifying Circumstances

99100, 99116, 99135, 99140

High-dollar miss

Direction Modifier Accuracy

QK, QX, QY, QZ confusion

22% denial rate

ASA Base Unit Selection

Wrong CPT = wrong base

Critical error

Discontinued Procedures

Modifier 52, 53, 73, 74

Revenue loss

Cardiac/Neuro Premium

Complex case undercoding

Systematic miss

Post-Op Pain Management

01996 never captured

Untapped revenue
You trained for years in advanced anesthesiology. But right now, coding errors cost more than three anesthesiologists' combined salaries.
Cumulative Revenue Variance
$840,000+
Per Annum Potential
See How Much Revenue You're Leaving Behind
  • Industry Problem

Why General Medical Billing Companies Fail Anesthesiology Practices

Anesthesiology billing demands mathematical precision and modifier expertise that generalists simply don’t have.

Time calculation chaos

Can't convert minutes to units correctly (every 15 minutes = 1 unit)

Physical status blindspot

Never apply P3, P4, P5 modifiers (significant reimbursement boost)

Qualifying circumstance miss

Don't capture age extremes, emergency, hypothermia add-ons

Direction modifier confusion

Mix up QK (medical direction 2-4 CRNAs) vs QX (CRNA supervised)

ASA base unit errors

Select the wrong anesthesia CPT code = wrong base calculation

MAC undercoding

Don't recognize when MAC deserves higher complexity coding

Discontinued procedure gaps

Don't apply modifiers 52, 53, 73, 74 correctly

Post-op pain loss

Never bill 01996 for epidural/nerve block management

Result: 28%–42% denial rates, systematic time undercoding, and massive modifier-related revenue loss.

  • The NEO MD Difference

The Neo MD Anesthesiology Advantage

Anesthesiology-Certified Coding Teams

  • Time calculation mastery (start/stop to billable units)
  • Physical status modifier expertise (P1-P6)
  • Qualifying circumstances capture (99100, 99116, 99135, 99140)
  • Medical direction vs supervision (QK, QX, QY, QZ)
  • ASA base unit accuracy
  • Complex cardiac and neuro anesthesia

→ 95–97% clean claim rate vs 58–72% industry average

Time-Based Revenue Maximization

  • Precise start time — Anesthesia induction begins
  • Precise stop time — Patient transferred to recovery
  • Accurate unit conversion — 15-minute increments
  • No rounding errors — Capture every billable minute
  • Documentation standards — Start/stop time verification

→ $14K–$32K monthly recovery from time accuracy

Physical Status Modifier Optimization

  • P1 — Normal healthy patient (baseline)
  • P2 — Mild systemic disease (slight increase)
  • P3 — Severe systemic disease (significant boost)
  • P4 — Life-threatening systemic disease (major increase)
  • P5 — Moribund patient (maximum reimbursement)
  • P6 — Brain death (organ donation cases)

→ $12K–$28K monthly from physical status modifiers

Qualifying Circumstances Revenue

  • 99100 — Anesthesia for patients of extreme age (<1 year or >70 years)
  • 99116 — Anesthesia complicated by total body hypothermia
  • 99135 — Anesthesia complicated by controlled hypotension
  • 99140 — Anesthesia complicated by emergency conditions

→ $8K–$18K monthly from qualifying add-ons

Medical Direction & Supervision Clarity

  • QK — Medical direction of 2-4 CRNAs (anesthesiologist present)
  • QX — CRNA service with medical direction
  • QY — Medical direction of 1 CRNA (teaching case)
  • QZ — CRNA without medical direction
  • AA — Anesthesiologist assistant services

→ Correct modifier application = proper reimbursement

Real-Time Revenue Intelligence

  • Daily case-level time tracking
  • Weekly modifier accuracy monitoring
  • Monthly performance by procedure type
  • Quarterly ASA base unit audits

→ Complete transparency

Request Your Free Revenue Assessment

Anesthesiology Services We Master

General Anesthesia

Induction and maintenance of general anesthesia for surgical procedures with precise time tracking from anesthesia start to patient transfer, ASA base unit determination for correct procedure coding, physical status modifier application based on patient comorbidities, medical direction or supervision modifier accuracy, and qualifying circumstances add-ons when criteria are met.

Regional Anesthesia

Spinal anesthesia for lower extremity and abdominal procedures, epidural anesthesia for labor, delivery, and surgical cases, peripheral nerve blocks including upper and lower extremity blocks, continuous catheter techniques for post-operative pain management, and combined spinal-epidural techniques for complex cases.

Monitored Anesthesia Care (MAC)

MAC for endoscopy procedures with appropriate sedation level documentation, MAC for ophthalmologic surgery, including cataract and retinal procedures, MAC for interventional pain management procedures, MAC for cardiovascular procedures, including cardiac catheterization, and complex MAC cases requiring higher-level coding due to patient comorbidities.

Cardiac Anesthesia

Coronary artery bypass graft (CABG) anesthesia with CPB, valve replacement and repair procedures, heart transplant anesthesia, off-pump cardiac surgery, congenital heart defect repair, and ECMO cannulation and management.

Neuroanesthesia

Craniotomy for tumor resection with neuromonitoring, aneurysm clipping and coiling procedures, spine surgery anesthesia including complex multilevel fusions, awake craniotomy for mapping procedures, and stereotactic procedures with frame placement.

Obstetric Anesthesia

Labor epidural analgesia with appropriate time tracking, cesarean section anesthesia (spinal, epidural, general), vaginal delivery anesthesia for complicated deliveries, post-partum tubal ligation, and management of obstetric emergencies, including hemorrhage and eclampsia.

Real Results: Real Results: 8-Anesthesiologist Hospital Group (Florida)

“We were losing massive revenue on time calculations alone. Neo MD fixed our physical status modifier usage, captured qualifying circumstances we never billed, and corrected our medical direction coding. Revenue is up 33% without adding cases.”

— Dr. Patricia R., Anesthesiologist

Get Your Practice's Revenue Analysis
Metric Before NEO MD After NEO MD (90 Days)
Denial Rate on Anesthesia Claims 34% 3.2%
Annual Revenue Loss $820,000 Recovered
Anesthesia Time Calculation Accuracy Consistently Incorrect +$22,000 / month
Physical Status Modifiers (P3–P5) Rarely Applied +$18,000 / month
Qualifying Circumstances Billing Never Billed +$12,000 / month
Medical Direction Modifier Accuracy Incorrect Usage +$14,000 / month
Total Revenue Impact Missed Revenue $78,000 / month
($936K annually)

Free Download

Anesthesiology Denial Prevention Checklist

The exact checklist our coders use for 95%+ clean claims.

Time calculation worksheet (minutes to units conversion)

Physical status modifier decision tree (P1-P6 criteria)

Qualifying circumstances guide (99100, 99116, 99135, 99140)

Medical direction modifier selector (QK, QX, QY, QZ, AA)

ASA base unit referenced by CPT code

Discontinued procedure modifier guide (52, 53, 73, 74)

MAC complexity documentation template

Post-operative pain management billing (01996)

Used by 110+ anesthesiology groups. Worth $3,200. Yours free.

Download Anesthesiology Checklist

Performance: Neo MD vs Industry Standard

Performance Metric Industry Avg Neo MD
Clean Claim Rate 58–72% 95–97%
Denial Rate 28–42% 3–6%
Time Calculation Accuracy 68–79% 99%+
Physical Status Modifier Use 32–52% 96%+
Qualifying Circumstance Capture 18–38% 94%+
Direction Modifier Accuracy 64–78% 98%+

Our Process: Revenue Acceleration in 90 Days

Step 1 (Week 1)
Free 90-Day Revenue Diagnostic

We begin with a comprehensive analysis of your last 90 days of anesthesia cases, examining every claim for time calculation accuracy from documented start and stop times, reviewing physical status modifier application against patient charts and ASA classifications, evaluating qualifying circumstances eligibility based on patient age and case complexity, and assessing medical direction versus supervision modifier correctness. Our team identifies denial patterns by case type and payer, reviews ASA base unit selection for procedure coding accuracy, and examines MAC cases for appropriate complexity coding. You receive a detailed report showing exactly where revenue is leaking with specific case examples and the dollar amount being lost to each type of time calculation error, missing modifier, or incorrect base unit selection.

Step 2 (Weeks 2-3)
Seamless Transition

Our implementation team coordinates a smooth transition with zero disruption to your OR schedule or hospital relationships. We integrate with your anesthesia information management system whether you're using Epic Anesthesia, Picis, GE Centricity Anesthesia, or any other platform, verify all payer enrollments and hospital privileges, set up time tracking protocols with automatic start/stop validation, establish physical status modifier prompts based on patient comorbidities, and provide comprehensive training to your anesthesiologists, CRNAs, and billing staff on precise time documentation standards, physical status criteria, qualifying circumstances identification, and medical direction modifier selection. Most groups have their first clean claims submitted within 10-12 business days.

Step 3 (Days 30-90)
Revenue Acceleration

This is where you see immediate financial impact. Our certified anesthesiology coders begin implementing precise time-to-unit calculations, capturing every billable minute, systematically applying physical status modifiers P3-P5 on every case meeting ASA criteria, capturing qualifying circumstances for age extremes, emergencies, and complications that were previously missed, and ensuring correct medical direction and supervision modifier application for every CRNA case. We systematically rework and resubmit old denied claims with corrected time calculations and proper modifier application. Within the first 30 days, most practices see noticeable cash flow improvement from physical status modifiers and time accuracy alone, and by day 90, our clients average a 28-33% revenue increase without adding OR cases or extending coverage hours.

Step 4 (Ongoing)
Continuous Optimization

 Revenue optimization doesn't stop at 90 days. We provide bi-weekly updates on anesthesia coding changes and ASA-based unit modifications as CMS publishes updates, conduct monthly case coding reviews with your anesthesia team to ensure continued time documentation accuracy and modifier compliance, perform quarterly compliance audits on medical direction ratios and physical status modifier appropriateness, and deliver annual CPT code update training specific to anesthesiology services. As your practice expands services like regional anesthesia programs, chronic pain procedures, or acute pain management, we proactively research coverage policies and implement billing protocols to ensure maximum reimbursement from day one.

Start Your Revenue Assessment

Critical Compliance Issues We Handle

Anesthesiology practices face unique regulatory scrutiny. We protect you:

Time documentation accuracy

(exact start/stop times, no gaps or overlaps)

Physical status modifier justification

(patient chart supports P3-P5 designation)

Qualifying circumstances criteria

(age, emergency, complication documented)

Medical direction ratio compliance

(1:4 maximum for full reimbursement)

ASA base unit accuracy

(correct anesthesia CPT code selection)

Concurrent case documentation

(overlapping cases properly tracked)

Pre-anesthesia evaluation

(required documentation before surgery)

Discontinued procedure modifiers

(52, 53, 73, 74) were appropriately applied.

We keep you compliant, paid, and audit-ready.

Frequently Asked Questions

10–14 days, zero OR schedule disruption.

 Yes. We work with Epic Anesthesia, Picis, GE Centricity, and all major AIMS platforms.

 We ensure correct QK, QX, QY, QZ modifier application based on actual case supervision.

 7–10% of collections, but clients average a 28–33% revenue increase.

 Yes. We handle both employment models and various contract structures.

 We optimize high-complexity anesthesia with appropriate base units and modifiers.

  • Financial Attrition Warning

Stop Losing $30K–$70K Every Month

Every month you delay is another month of compounded clinical leakage.

Time calculations are systematically wrong

Physical status modifiers never applied

Qualifying circumstances uncaptured

Medical direction modifiers are incorrect

ASA base units miscalculated

MAC cases undercoded

Partner with Neo MD

Operational Performance Protocol

90 Day scaleability
Clean Claims Rate
95–97%
Denials below 4%
60 Days
Revenue up 28–33%
90 Days
Time accuracy
99%+
Physical status modifiers
96%+
Direction modifiers
98%+

Qualifying circumstances

94%+

Two Ways to Get Started

Option 1

Free Revenue Analysis

No obligation. No sales pitch. Just data.

We’ll show you:

  • Time calculation accuracy (start/stop to units)
  • Physical status modifier usage (P3-P5 opportunities)
  • Qualifying circumstances capture rate
  • Medical direction modifier correctness
  • ASA base unit selection accuracy
  • Missed revenue by case type
Request Free Revenue Analysis

Option 2

Talk to a Specialist

15-minute consultation. Zero pressure.

We’ll discuss:

  • Your current billing challenges
  • Time calculation and modifier gaps
  • Physical status and qualifying circumstance opportunities
  • Whether Neo MD is the right fit
Schedule 15-Minute Call

Or call us directly:

  • (929) 502-3636

Monday-Friday, 8 am-5 pm EST

The Cost of Waiting

If you’re an anesthesiology group collecting $5.8M annually and losing 30% to billing inefficiencies

$1,740,000

Per year in lost revenue

$8.7 million

Over 5 years

That’s hiring additional anesthesiologists, expanding regional anesthesia programs, investing in advanced monitoring equipment, or building comprehensive chronic pain management services.

Every month you wait costs you $145,000 you'll never recover.

The question isn’t “Should I switch?”
The question is: “How much more am I willing to lose?”

Get Your Free Analysis

Neo MD Inc. | Anesthesiology Medical Billing Specialists




    Trusted by 110+ anesthesiology groups across all 50 states