# Prolong Visit for Anesthesia



## caroline75771 (Jan 15, 2010)

Can an aneshtesiologist bill for EM & prolong time for "patient complication" on  postcare?
Thank you.


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## jdrueppel (Jan 18, 2010)

Need more information before I can answer.  Please specify the what, when and where the patient complication occured.

Julie D, CPC


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## caroline75771 (Jan 20, 2010)

The question was asked hypothetically by our administrator. We are about to open an Amb Surg within our group and hiring different specialties and anesthesiologists.


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## jdrueppel (Jan 24, 2010)

The anesthesia postop round is inclusive of the anesthesia service.  Per the CCI all inpatient and outpatient visits and consults occuring on the same day by same provider/group/specialty as the anesthesia service are inclusive with a modifier status of "0" which means this edit cannot be over-ridden with a modifier.  However, E&M services occuring on or after postop day 1, excluding the anesthesia postop round, that are above and beyond the usual postop care can be billed in accordance with CPT Billing Guidelines. 

Note: some payers may require the -24 modifier to signify unrelated postop E&M service.

Julie, CPC


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## caroline75771 (Jan 27, 2010)

Julie,Thank you for your response.  But is'nt there anything the anesthesiologist can bill if the anesthesia postop became complicated ?
Thanks.


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## jdrueppel (Jan 28, 2010)

Of course, the anesthesia provider may report medically necessary surgical procedures, however, E&M services are not allowed unless it would qualify as critical care (which then, per critical care billing instructions, total critical care time would exclude any procedure time).  

The below excerpt is from the NCCI Chapter 2 (Anesthesia) page 5

"Similarly, routine postoperative evaluation is included in the basic unit for the anesthesia service. If this evaluation occurs after the anesthesia practitioner has safely placed the patient under postoperative care, neither additional anesthesia time units nor evaluation and management codes should be reported for this evaluation. Postoperative evaluation and management services related to the surgery are not separately reportable by the anesthesia practitioner except when an anesthesiologist provides significant, separately identifiable ongoing critical care services.
Anesthesia practitioners other than anesthesiologists cannot report evaluation and management codes except as described above when a surgical case is canceled."

Julie, CPC


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