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Patient Monitoring Only

  1. Question Patient Monitoring Only
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    Our Anesthesiologists are being requested by the surgeon to monitor a patient (due to his/her poor physical status) who may need to be given anesthesia if any complications during the surgery would arise. Our question is if there is any code that we could bill for this situation? Our thoughts were that maybe we could bill under an E/M code for a consultation if the correct documentation is on file or could we bill as MAC even though no anesthesia may be given. Thank you in advance for any information.

  2. #2
    In order to bill MAC your anesthesia provider would need to satisfy all documentation requirements of an anesthesia service...pre-op eval, documentation of intra-operative monitoring (timeline documentation)....and all components. If he/she is doing this then MAC could be billed. MAC does not necessarily include administration of an anesthestic agent - the ASA Relative Value Guide defines MAC in no nonsense terms. If the anesthesia provider is merely present during the procedure without anesthesia record documentation and time is greater then 30 minutes then you may be able to bill stand-by CPT 99360 IF your provider appropriately documents the service (requested by whom, for what reason-medical necessity, for what procedure, times). Keep in mind that standby may not be covered by all carriers. Given the information provided it does not appear an E&M or consultation is substantiated.

    Julie, CPC

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