Anesthesia Coding Alert

Hint: Watch consciousness, not just airway.

Monitored anesthesia care (MAC) is a specific anesthesia service that keeps the patient very drowsy and unable to feel pain during the procedure. According to the American Society of Anesthesiologists' position statement, MAC "includes all aspects of anesthesia care --" a preprocedure visit, intraprocedure care, and postprocedure anesthesia management. During monitored anesthesia care, the anesthesiologist provides or medically directs a number of specific services. ..." Those services can range from diagnosis and treatment of clinical problems that occur during the procedure to administering sedatives or other medications for patient safety or providing other medical services as needed during the procedure.

Key difference: Monitored anesthesia care may include varying levels of sedation, analgesia, and anxiolysis as necessary. Questions often arise about the difference between MAC and general anesthesia, but you really only need to remember one thing: If the patient loses consciousness and the ability to respond purposefully, you're coding for a general anesthetic, ASA states --" regardless of whether the patient requires airway instrumentation.