Difficult Case - Ophthalmology ASC MAC Anesthesia

saddie2k

New
Messages
7
Best answers
0
Can anyone help with how to code this scenario...

Patient presents to pre-op (ASC) and MAC anesthesia is started. Patient is taken to a laser suite to have Femtosecond Laser prior to their cataract surgery. The patient becomes non-compliant and the laser (not billable to insurance) is aborted. The patient is returned to PACU and MAC anesthesia is stopped a few minutes later. The surgeon/CRNA/Family member discuss how best to proceed with the cataract surgery, completely aborting the laser. One hour later MAC anesthesia is started again followed by successful phaco. The first session of anesthesia lasted 31 minutes and the 2nd was 18 minutes. Since the billable surgical procedure was never even started during the first session how can I credit my CRNA with the time? The case ended up having 3 CRNA's in the room for the second session although I don't think that will matter. I have coded for ophthalmology almost 15 years...but I am new with the anesthesia aspect. Any help would be GREATLY appreciated!
 
Messages
89
Best answers
0
If I'm understanding this correctly you need to start with the payer's policy to see if it covers anesthesia services performed for a non-covered procedure. I haven't come across a payer that does, but there are so many payers and I haven't read all of their guidelines so I hesitate to use a word like "never."

For the general rule on anesthesia time, see the latest guideline from the ASA: https://www.asahq.org/quality-and-practice-management/managing-your-practice/timely-topics-in-payment-and-practice-management/2019-relative-value-guide-updates-include-anesthesia-time-and-field-avoidance
 
Top