Monitored Anesthesia Care I am having trouble getting claims for MAC paid. What could be the problem? First of all, each state has a LMRP for MAC (Monitored Anesthesia Care). Within these policies there are anesthesia codes for which no other documentation is necessary to support the necessity of MAC (column A codes). Column B…

Medical direction may apply to a single anesthesia service furnished by a CRNA or up to fourconcurrent anesthesia services. A physician who is directing the administration of anesthesia to foursurgical members is not expected to be involved routinely in furnishing any additional services to othermembers. Addressing an emergency of short duration in the immediate area,…

Limitations Based on the CPT Definitions 99143–99145 An independent trained observer whose sole duty is to monitor the patient’s level of consciousness and physiological status must be present throughout the diagnostic or therapeutic service. The anesthesia note must identify this person and his credentials (e.g., RN, NPP, PA).  “Intra-service time starts with the administration…

Intractable Pain and Epidural Catheters Some forms of conventional therapy such as oral medication, physicaltherapy, or a TENS unit may not relieve recipients with intractable pain.Placement of an epidural catheter may be allowed when medically necessaryfor recipients with intractable pain. Reimbursement for daily management isallowed when it is medically necessary and is a separately identifiablephysician-recipient…