Anesthesia Coding Alert

Question: Can you point me to a resource to explain how to bill for interrupted time?

South Dakota subscriber

Answer: Interrupted time, which is also referred to as discontinuous time, is explained in Chapter 2 – Anesthesia Services in the National Correct Coding Initiative (NCCI) Policy Manual. According to the NCCI, “In counting anesthesia time, the anesthesia practitioner can add blocks of time around an interruption in anesthesia time as long as the anesthesia practitioner is furnishing continuous anesthesia care within the time periods around the interruption.”

In the chapter, NCCI uses placement of a retrobulbar block for cataract surgery as an example. This is not the best example to use, as these cases often are multiple cases being medically directed. However, the NCCI further explains “if it is medically necessary for the anesthesia practitioner to continuously monitor the patient during the interval time and not perform any other service, the interval time may be included in the anesthesia time” (emphasis added).

A better example would be if a case is interrupted or delayed for a documented reason, such as a surgical delay. In that case, the two documented blocks of time could be added together. For example, suppose the patient is taken to the operating room (OR) for surgery at 9:11 and anesthesia begins to prepare the patient. However, there is an equipment failure at 9:21 that delays the case. Anesthesia stop time at this point is 9:21 (this is the first block of ten minutes). The equipment is then fixed or changed, and the case begins again at 10:21 and ends at 14:07 (this is the second block of 226 minutes). This gives a total of 236 minutes (10 + 226), which you would report as documented anesthesia time. Time from 9:22 to 10:20 is not separately billed by the anesthesia provider.