When billing for many anesthesia services anesthesia modifiers are used in order to indicate the different time units involved in the anesthesia service. On January 1st, 2019, MSP introduced a new fee code for Anesthetic modifiers, P01169. Since then, the amount for this fee code has gone up.
P01169 is based off of your patients BMI (Body Mass Index) score, which is the estimate of your patient’s body fat based on their weight and height. The modifier works on increments of 15 minutes. MSP increased the amount of P01169, so it now pays $20.69 per 15 minutes (as opposed to the beginning of the year when it was $20.54.)
|Fee Code||Description||Amount $|
|P01169||BMI ≥ 35 – per 15 minutes or part thereof||$20.69 (a .15 increase from January 1st).|
- Restricted to certified specialists in Anesthesiology
- Payable only when fee items 01172, 01173, 01174, 01175, 01176,01177, 01178, 01179, 01180, 01181, 01005, 01106, 01110,or 01111 are also payable.
- Applicable to all patients who are 19 years of age or older, with a BMI of 35 or more. It’s also applicable for patients who are younger than 19 who have a BMI with at least 97th percentile adjusted for age and gender.
- The patient’s BMI must be provided in the claim note record and documented on the patient’s anesthetic record.
Medical billing in BC is confusing and can often be overwhelming. To help out, check out our complete MSP guide that walks you through each step of medical billing – from the general teleplan process to maximizing your claims and using mobile billing.
Start and End Times
To bill 01169 on the Dr. Bill app, simply
- Select 01169 as the fee code,
- Add a diagnosis (fill out your claim as usual),
- Enter in your start and stop times,
- Add a Referring Physician
- Click save.***Based on your start and stop times the app will automatically calculate the number of units there were. In the example below, Page 1 shows the claim filled out, with the start and end times. After clicking save you can see page 2.Page 2 shows the total claim amount based on the start and end times. In this example 8 units were calculated (8 x $20.69 = $165.52).
If you have any questions on billing the Anesthesia Modifier P01169, contact our billing team here.
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
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