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A Certified Registered Nurse Anesthetist (CRNA) is a type of advanced practice nurse who administers anesthesia in the United States.CRNAs account for approximately half of the anesthesia providers in the United States and are the main providers (80%) of anesthesia in rural America. [1]
Certified Registered Nurse Anesthetists are advanced practice registered nurses specializing in the provision of anesthesia care. As of 2018, CRNAs represent more than 50% of the anesthesia workforce in the United States, with 52,000 providers, according to the American Association of Nurse Anesthetists, and administer more than 40 million anesthetics each year.
The AANA began accrediting nurse anesthetist programs in 1952 [6] and was recognized as an accrediting body by the U.S. Department of Education in 1955. [2] In 1975, the accreditation of nurse anesthesia educational programs transitioned from the AANA to the autonomous Council on Accreditation of Nurse Anesthesia Educational Programs (COA). [6]
In the United States, nurse anesthetists are called Certified Registered Nurse Anesthetists (CRNAs). CRNAs account for approximately half of the anesthesia providers in the United States and are the main providers of anesthesia in rural America. [3] Nurses have been providing anesthesia care to patients since the American Civil War. [4]
Studies have found evidence that anesthesiologists engage in anomalous billing and revenue-maximizing behavior by inflating the time spent providing care. [ 9 ] [ 10 ] In 2024, Anthem proposed changes to its insurance reimbursement in several states, implementing a time limit for anesthesia care, refusing to reimburse beyond the time limit. [ 11 ]
The American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association (ANA), is a certification body for nursing board certification and the largest certification body for advanced practice registered nurses in the United States, [1] as of 2011 certifying over 75,000 APRNs, including nurse practitioners and clinical nurse specialists.
It was modified and revived in the 1990s, primarily by chiropractors, and also by osteopathic physicians; this was likely due to safer anesthesia used for conscious sedation, along with increased interest in spinal manipulation (SM). [26] In the MUA literature, spinal manipulation under anesthesia has been described as a controversial procedure.
In 1982, after much work and debate, the UB-82 emerged as the endorsed national uniform bill. After an 8-year moratorium on change, the UB-82 was replaced by UB-92, and became the standard for billing paper institutional medical claims in the United States, until creation of the UB-04.