Wiki Anesthesia Billing

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howardl

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Our practice recently had a board meeting and one of the questions that was brought up:

Example 1:
When our physicians enter the OR and the patient is awake and the physician does placement of the lines; is it appropiate to bill for anesthesia start time while they are placing the lines or should they start anesthesia time after lines are placed?

Example 2:
When our physicians enter the OR and the physician does placement of the lines after the patient is asleep is it appropiate to bill both anesthesia start time and also bill for the lines although the same physician is placing the lines.

Our assumption of this is that the physician can go to the OR & start anesthesia time then place the lines because we are billing for the anesthesia and then we are billing the lines which are considered a surgical procedure.

Thank you for your opinions/advice :D
 
I believe your understanding is correct. We bill from the time the anesthesiologist enters the or with the patient and bill for the lines
 
There has been a lot of debate surrounding this issue. However, both the AMA and ASA have put forth the position that line placement (whether in pre-op holding or in the OR prior to induction) are not time based services.

Lines placed after induction require medical necessity.
 
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Anesthesia Time and Lines

The debate continues on when to start anesthesia time in the heart room, when lines must be placed.

Some groups have been advised to take a chunk out of their time while inserting their art lines and CVPs even though they are with the patient in the operating room monitoring their condition and sedating them. In other situations when a case becomes difficult and an anesthesiologist/CRNA must start an art line in the middle of the case no one questions continuing uninterrupted time.

We understand ASA and AMA spoke on this but would like to know the references. Most importantly has anyone seen a comment from one of the MACs on this issue?

Thank you for your insight.
 
Anesthesia Billing Time and Lines

Thank you for the insights but I still would like to see a reference from AMA, ASA or a MAC. Has anyone seen this? Any help would be appreciated. Thanks.
 
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