Based upon an article I read; via AAPC Blog…"Bill the case either under the name of the physician who spent the most time with the patient or under the name of the physician who started the case."

This is the documented scenario:
Primary AA/CRNA: AnesStart 12:28/OpStart 13:02/OPEnd 15:20/AnesEnd 15:29
Relief AA/CRNA: Start 13:18 to End 13:24

Q1. In this scenario the Primary AA/CRNA (181 minutes @ 12.1 TIME UNITS) represents longest time & started the case…correct?

Q2. I also presume from the above statement, that the relief provider’s documented time is NOT CAPTURED and/or SUBMITTED as a charge?

Q3. Or, do we at any point deduct the relief providers time from the primary provider total time?

Q4a. Is there any scenario where the lesser relief providers time can/should be submitted?
Q4b. OR, is that considered "double dipping"?

Q5. if Q4 it is possible, would the BASE + ASA unit be included along with the TIME?
I have seen same end times documented by the primary and relief (although relief provider total time is less); in which case I will submit as noted above

Q6. But, when both relief & primary start & end times are the same…how is that handled?

Q7. And would that be a scenario where relief TIME + BASE + ASA be submitted along with primary total units…creating a two line charge entry?

Q8. My understanding is that the 99100-99140 & ASA (P1-P6) are NOT payable by Medicare. If it is the primary and I know there is a secondary can I still submit those elements and; it not be consider fraud (knowingly); as I will need for the secondary payer?

Thank you so much for assisting me in understanding this specialty