QY Clarification on Time Reporting

Muncie, IN
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I am needing clarification on QY/QK/AD when only one Anesthesiologist, one CRNA, and one Surgeon is involved in two cases.
Here's the situation:

Two rooms
Room#1: Patient 1 case begins, Both providers are present and actively attending the case (started as medical direction). Then the MD leaves the room early to begin/prep a case in room#2. The second case does not actually start until the CRNA is present and the MD returns once the case is finished and the CRNA has left the room to attend the second case. Md performs the Post-eval per medical direction guidelines. (But my concern is that anesthesia times appear as overlapping with case#2!)
Example time: Anes start: 12:40 Surg start: 12:55 MD leaves room: 13:20 Surg End: 13:45 Anes End: 13:58 MD came back for post eval afterwards

Room#2: Patient 2 case begins MD is present for prep and remains with patient until the case 1 surgery has completed and leaves briefly for post eval. CRNA is now present and procedure is underway. MD returns once post-op eval was completed for patient 1.
Example time: Anes start: 13:48 CRNA in: 13:58 Surg start: 14:00 (not sure when MD leaves room to do post op eval of pt 1) Surg End: 14:25 Anes End: 14:38

(These times are completely hypothetical) But anes time on claims look like:
Case#1: 12:40-13:58
Case#2: 13:48-14:38 CRNA would report: 13:58-14:38

Can we continue to bill as QY since only one CRNA is being medically directed, or since some of the case times will overlap, will this be QK? Or finally, since times overlap we bill AD for supervision only?

Should we just make sure all the discontinued times are well documented and continue to bill QY?
Is anyone else having this issue?

Thanks so much! My head is trying to process all the different factors and I want to make sure we are following all requirements! 😄


Sherman, TX
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