We need additional clarification on the situational rule for 837P 2300 HI BP for the Anesthesia Related Procedure. It states that it is required on claims where anesthesiology services are being billed OR reported when the provider knows the surgical code AND knows the adjudication of the claim will depend on provision of the surgical code.
If it is an anesthesia service or the provider knows the surgical code, should the condition that the surgical code will impact adjudication be met in order to satisfy the rule for the data to be submitted?
As you stated, the 2300 HI – Anesthesia Related Procedure Situational usage rules states “Required on claims where anesthesiology services are being billed or reported when the provider knows the surgical code and knows the adjudication of the claim will depend on provision of the surgical code. If not required by this implementation guide, do not send.”
The usage rule has two conditions that must be met to make the segment required. First, anesthesiology services are being billed or reported when the provider knows the surgical code, and secondly knows the adjudication of the claim will depend on provision of the surgical code. If both conditions are true, the segment must be sent.