Anesthesia Coding Alert

Before a case can be considered medically directed, CMS mandates that the anesthesiologist meet several criteria, sometimes called the "seven rules of medical direction":
 

Perform a preanesthesia examination and evaluation
 

Prescribe an anesthesia plan
 

Personally participate in the most demanding procedures of the anesthesia plan, including induction and emergence
 

Ensure that any procedure in the plan that he or she does not perform is performed by a qualified anesthetist;
 

Monitor the course of anesthesia administration at intervals
 

Remain physically present and available for immediate diagnosis and treatment of emergencies
 

Provide indicated postanesthesia care.

 
Debra Hecht, CCS-P, is assistant administrator with Professional Anesthesia Services of Akron, Ohio, which employs 12 anesthesiologists and 50 CRNAs. "While we do a lot of billing for anesthesia services provided by CRNAs, we always have a physician on call," Hecht says. "In this way, we can assure that there is always an anesthesiologist available to provide medical direction or supervision if required or to take over a case."