ASA: How to Reprocess Claims Made With Erroneous Anesthesia Conversion Factors

Though CMS recently increased its original anesthesia conversion factors for 2012, physician groups must determine if it is in their best interest to reprocess the limited number of claims made prior to the corrected rate, according to a report from the American Society of Anesthesiologists.

CMS announced in mid-March an error in calculating the previous anesthesia conversion factors. The revised numbers increased the CF to $21.52, and the locale-specific CFs increased between $0.08 and $0.13 per unit. Any claims processed between January 1 and March 1 would have used the erroneous rate previously provided by CMS.

"Due to a change in their procedures, the practice expense component of the CF did not include the inputs that represent scheduling/case assignment/coordination/form completion activities associated with each anesthesia code," the ASA report said. "CMS disclosed that the error originated with the 2011 CF and was carried over into 2012.  This additional information may change the picture for groups as they determine whether to request reprocessing as the number of impacted claims has increased."

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