March 18, 2022
Update 3/28/2022: Check your Payments for CPT® Code 00537 - Anesthesia for Cardiac Electrophysiologic Procedures Including Radiofrequency Ablation
Noridian Healthcare Solutions, the Medicare Administrative Contractor for AK, AZ, ID, MT, ND, OR, SD, UT, WA and WY recently noted that it had been underpaying claims for this anesthesia service. The Medicare Base Unit value increased from 7 to 10 units effective January 1, 2022 but their system had not made this update. Noridian will identify and re-process the underpaid claims. ASA is appreciative of Noridian taking this action and not requiring anesthesiologists to re-submit these claims. ASA encourages all practices to check their payment for this service from all payers to confirm that they are receiving the accurate amount.
Update 3/28/2022: Since posting this information, we have since learned that at least one other Medicare Contractor has also underpaid claims for code 00537. This makes it more urgent that practices review their payments for this anesthesia service to confirm that the payment is calculated using a base unit value of 10.