Anesthesia Coding Alert
Remember This Detail About MAC
Question: The case I’m billing for was scheduled as MAC (monitored anesthesia care). The anesthesiologist could not get a good IV stick and remained present to monitor the patient for the procedure while the surgeon administered local anesthesia. I feel the anesthesiologist should be able to bill for something since he remained present for at least 45 minutes. What’s your advice for coding? Should I append any modifiers? Texas Subscriber Answer: From the information you share, this sounds like a MAC case because of the service your anesthesiologist provided. Remember, the American Society of Anesthesiologists guidelines state that the patient does not have to be sedated for it to be MAC. Caveat: Make sure the documentation includes both pre- and post-anesthesia care, even if no drugs were administered, as well as monitoring during the procedure. The payer in question might have tougher medical necessity requirements. Check the policy before submitting the claim.
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