A Guide To Monitored Anesthesia Care
Intra-operative monitoring by an anesthesiologist, physician, or other qualified individual under the medical direction of the anesthesiologist, of the patient’s vital physiological signs in anticipation of the need for administration of general anesthesia or of the development of adverse physiological patient reaction to the surgical procedure. MAC is eligible for coverage when performed by the anesthesiologist or the CRNA/AA and includes all of the following criteria:
- MAC is requested by the attending physician or operating surgeon.
- There is performance of a pre-anesthetic examination and evaluation.
- There is a prescription of the anesthesia care required.
- Administration of necessary oral and parenteral medications takes place.
- There is personal participation in, or medical direction of, the entire plan of care.
- There is continuous physical presence of the anesthesiologist or, in the case of medical direction, of the qualified anesthetist being medically directed (must be present in the operating suite during the operative procedure) or proximate presence within vicinity of the operating suite or availability of the anesthesiologist for diagnosis or treatment of emergencies.
- Usual non-invasive cardiovascular and respiratory monitoring occurs.
- Oxygen is administered, when indicated.
- There is intravenous administration of sedatives, tranquilizers, anti-emetics, narcotics, other analgesics, beta-blockers, vasopressors, bronchodilators, anti-hypertensives, or other pharmacological therapy that may be required in the judgment of the anesthesiologist.
Moderate (conscious) sedation is a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.
Moderate sedation does not include minimal sedation (anxiolysis), deep sedation or monitored anesthesia care (00100-01999).