anesthesia start and end

[tennisballs]

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For economic purposes, when is it considered fair to document "anesthesia start?" Is it when the resident begins interviewing the patient pre-op? Is it when the attending interviews the patient? Or when we bring the patient in the room?

Along the same lines, do we document "anesthesia end" when the patient leaves the OR? Or is it when we have finished dropping off the patient and giving report to the accepting provider?

Probably sounds like a silly question but in a hospital with a large case volume this could make a big difference in reimbursement.

 

[Endee]

At our place, we have four time blocks with a start and end. First is anesthesia pre-op, which includes workup for a patient in the holding area, preop IVs/A-lines, talking with the patient, formulating the plan, etc. Then there's room start/end, which is entering and leaving the room. Then there's surgery start/end, and the last is pacu start/end, which is arriving at pacu and ends after the handoff is finished.

 

[leaverus]

yeah, this always confuses me too. i've alway just written down "anesthesia start" as the time patient enters the OR and "endtime" as when i give report to pacu rn. since the actual anesthetic record varies from place to place, i think your best bet would to be ask your boss or the billing company that your group uses.

 

[jwk]

If I understand it correctly, the pre-op evaluation is already bundled into the fee, so you can't bill for that separately.

Anesthesia end time is when you have completed the process of transferring care of the patient to another provider, whether that is a PACU nurse, ICU nurse, etc.

I believe the only times that are important from a billing standpoint are anesthesia start/stop and perhaps procedure start/stop. That's it. "Leave OR" times and "Arrive PACU" times aren't important from a billing standpoint, but your facility may want them.

 

[RabbMD]

Once you establish uninterupted contact with your patient the anesthesia start time has started. The end is when you leave the pacu/icu. The exception to the start time is for non time dependent add ons like blocks for post op pain. You can not double bill for anesthesia time and a block, so your anesthesia time starts as soon as the block is done if you then have continuous contact. If you do the block and leave, then your start time is when you enter room with pt.

 

[urge]

For economic purposes, when is it considered fair to document "anesthesia start?" Is it when the resident begins interviewing the patient pre-op? Is it when the attending interviews the patient? Or when we bring the patient in the room?

Along the same lines, do we document "anesthesia end" when the patient leaves the OR? Or is it when we have finished dropping off the patient and giving report to the accepting provider?

Probably sounds like a silly question but in a hospital with a large case volume this could make a big difference in reimbursement.

Cannot bill for preop time, even if you spend 2 hrs. You can start billing as soon as you start placing an iv, or start moving the pt to the or.

 

[ph8]

For economic purposes, when is it considered fair to document "anesthesia start?" Is it when the resident begins interviewing the patient pre-op? Is it when the attending interviews the patient? Or when we bring the patient in the room?

Along the same lines, do we document "anesthesia end" when the patient leaves the OR? Or is it when we have finished dropping off the patient and giving report to the accepting provider?

Probably sounds like a silly question but in a hospital with a large case volume this could make a big difference in reimbursement.

from my understanding of "anesthesia start" and "anesthesia end", jwk and RabbMD answered OP's question...just consolidating into one post.

Anesthesia start = Once you establish uninterrupted care for your patient. (usually the time I ask the patient if they have any questions, give appropriate pre-medication, and start rolling outta pre-op.)

Anesthesia end = When you have completed the process of transferring care of the patient to another provider, whether that is a PACU nurse, ICU nurse, etc.