This isn’t a problem from a quantum physics pop-quiz. It is the denial anesthesia practices in WPS’s territory are seeing when their CRNA’s bill for ultrasonic guidance for needle placement (76942-26).
 
When Dottie Buck, Billing, Kearney Anesthesia Associates, P.C., Kearney, Neb. started getting denial PR-172 (Payment is adjusted when performed/billed by a provider of this specialty) when CRNA’s performed the professional component of the service (76942-26), she knew something was amiss. She reached out to the Anesthesia & Pain Coder’s Pink Sheet, which turned to the American Academy of Nurse Anesthetists.
 
Turns out that for reasons as yet unknown, WPS has stopped paying CRNAs for this service. But AANA is on it. “The AANA is aware of these denials for ultrasound guidance and has communicated with WPS Medicare to request that they resume direct reimbursement for this service,” replied Romy Gelb-Zimmer, associate director, federal regulatory and payment policy, for AANA’s Washington office. The agency does not currently know when WPS will fix this snafu. For now, AANA’s advice is to submit your claims and appeal the denials.
 
And our advice, keep an eye on upcoming issues of the Anesthesia & Pain Coder’s Pink Sheet for the final answer to this unexplained denial problem.