ACE Alert: Right on Time

A friendly reminder
In the past month, we have had several inquires regarding anesthesia time and what is billable.  We thought a simple reminder might benefit everyone! The definition of anesthesia time has not changed. 
Per the NCCI guidelines in Chapter 2:  
“Anesthesia time is defined as the period during which an anesthesia practitioner is present with the patient. It starts when the anesthesia practitioner begins to prepare the patient for anesthesia services in the operating room or an equivalent area and ends when the anesthesia practitioner is no longer furnishing anesthesia services to the patient (i.e., when the patient may be placed safely under postoperative care). Anesthesia time is a continuous time period from the start of anesthesia to the end of an anesthesia service. 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.”

CMS, ASA and most commercial carriers have this same definition or something very close to it.  There are a couple of helpful hints the ACE team would like to point out to groups.

  1. If you are going to start your time prior to arrival in the operating room, it is recommended that you include a note of medical necessity.  Remember, routine transport of the patient is bundled in the base units.
  2.  Sedation RNs are not qualified anesthesia providers and their time spent monitoring the patient should not be included in any billing.
  3.  Anesthesia end time should be supported with a transfer of care to PACU personnel.  Make sure those times align.
  4. Remember all pre-operative and post-operative visits are included in the base unit value and anesthesia time must support those activities outside of billable anesthesia time.  If you are making a late entry due to an EMR issue, it is best practice to label that entry as a late entry and refer to the actual time of the pre or post-operative visit.
  5.  Records that will be used if an outside audit occurs will be the circulating nursing record and the PACU record.  At least annually pull a sample of these records and compare them to what your anesthesia providers are reporting.  Assess your risk and provide education not only to your providers but also to hospital personnel as appropriate.

Anesthesia is one of the few specialties that are allowed to bill by including time.  It is an integral part of the anesthesia service, and it is our job to protect and validate this important component of the anesthesia service. If you have questions on anesthesia time or need help in doing a focused review on anesthesia time, we would love to help!

School is back in session with a new Critical Care Training! This session developed by ACE Expert, Judi Blaszczyk is a virtual training that is an hour long and worth 1 CEU from the AAPC. This training will educate coders, billers, and providers on the 2022 critical care guidelines. After viewing this training, the ACE team knows that individuals will become more confident in the elements needed for critical care time and documentation. 

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Our other new training out this summer is Coding Ancillary Lines. The coding and documentation of ancillary lines can be confusing! ACE expert Deena Gauthier has created a training that will help coders, billers, and providers understand the complexities of ancillary lines to ensure they are documented and coded correctly.

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We are here for your education and training needs! 
The ACE Team


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