# Time Question



## cmacpc (Nov 26, 2010)

I have a few cases where there is a large time gap between surgery end time and anesthesia end time  ex: 0305 anes end time: 0355. And yes they are still actually monitorring the patient recording vitals etc.  In the comments section on the anesthesia record "waiting for SICU bed".   Yes, I know the rule placed safely etc....  So my question is can you actually bill this much extra time, or would this be more or a staffing or hospital census issue????

TIA


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## dwaldman (Nov 26, 2010)

I looked at the Anesthsia guidelines in the claims processing manual
http://www.cms.gov/manuals/downloads/clm104c12.pdf

It says, "safetly under postoperative care" The only thing that came to mind is they would stay with the patient to the point that the recovery RN would take over monitoring. Depending on the type of surgery and the patient's reaction to the surgery and anesthesia immediately following the procedure. I usually only see up to about 7 minutes past once they get to recovery for more invasive surgeries. If they were waiting for a bed, wouldn't they pass the care onto the nurse and go back to the OR to prepare for the next patient for the next surgery. And not have that amount of time to stay with patient while there would be nurse there until they go to the overnight bed, unless there was something documented in the progress note of the chart or on the anesthesia record stating why there was prolong time in recovery area. If that is not there I would bring the record back and have them document it.


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## cmacpc (Nov 29, 2010)

Nothing out of the ordinary with the patient, and just a routine procedure say for instance a hernia repair or tonsilectomy.  I don't feel comfortable billing all the extra time, I feel that this is an issue that needs to be handled with the hospital due to the lack of space or staffing.


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