Anesthesia Coding Alert

Reader Question:

Different Anesthesia, Discontinuous Time

Question: A patient was scheduled for surgery with monitored anesthesia care (MAC), but a regional block was administered instead because of patient circumstances. Surgery didnt begin until 15 to 30 minutes after the block was administered. How should I bill this?

Wisconsin Subscriber

Answer: Bill this time if the anesthesiologist was in constant attendance and the patient was monitored during the 15 to 30 minutes before the surgery started. If there was no care, bill discontinuous time rather than the procedure. Time billed would start when the block was administered and run until the procedure ended. Youll also have to subtract the time in which there was no service. For example, the block was administered beginning at 8:03 a.m. and the procedure ended at
10:33 a.m. (total time: 90 minutes). If the anesthesiologist was not present between the block administration and the procedures actual start time, bill for 75 minutes. Show the time as 8:03-8:33 a.m. and 8:48-10:33 a.m. The 15-minute gap in the time sequence indicates the time the physician was not present.
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