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Wiki Please help answer this question

cherylbr

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I am billing for the anesthesiologist. The case was scheduled as MAC however the anesthesiologist could not get a good IV stick and remained present monitoring the patient for the procedure while the Surgeon performed a local.

How would you code this? I feel the anesthesiologist should be able to bill for something (as he remained present for at least 45 mins). What modifiers whoudl be applied? 52 or 53. Would this still require the QS modifier?

Please help!
Thank you.
 
I am billing for the anesthesiologist. The case was scheduled as MAC however the anesthesiologist could not get a good IV stick and remained present monitoring the patient for the procedure while the Surgeon performed a local.

How would you code this? I feel the anesthesiologist should be able to bill for something (as he remained present for at least 45 mins). What modifiers whoudl be applied? 52 or 53. Would this still require the QS modifier?

Please help!
Thank you.
Hi there, that sounds like MAC to me. The patient does not have to be sedated for it to be MAC: https://www.asahq.org/standards-and-guidelines/position-on-monitored-anesthesia-care
BUT - your payer policy may have tougher medical necessity requirements.
 
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