Anesthesia Coding Alert

Physician's presence must be documented Before you can report a case under the new guideline for teaching physicians, the anesthesiologist must document that he was present with the resident during the pre- and postanesthesia care and for all actual minutes of case time he bills. Here are some other tips to keep in mind when billing under this new guideline:

The new coding option only applies to two concurrent cases that both involve residents. If the anesthesiologist medically directs a CRNA in one room and supervises a resident in another room, you should report both as medical direction.

Be sure there are no overlapping minutes between the concurrent cases.

The physician isn't required to document his participation in induction and emergence (as is required for medical direction), but it's always a good idea to document these and other critical aspects of the case.

Append modifier -AA (Anesthesia services performed personally by anesthesiologist) for Medicare or other carriers (such as United Healthcare) that require teaching modifiers. You do not need to also append modifier -GC (This service has been performed in part by a resident under the direction of a teaching physician) because you should only bill for the physician's time with the patient.