You can't see patients or do other clinical activities while monitoring. All billing is based upon the idea that you are continuously monitoring a case. It is hard to schedule patients at all on days that you are monitoring because you are essentially at the whim of the surgeons. If it takes an extra hour to do a case, then you are there an extra hour. If you get an add-on case, then you are occupied for whatever time that case takes as well.
This is from the AAN guide:
"1. IOM is a procedure that describes ongoing electrophysiologic testing, and
monitoring performed during surgical procedures. It includes only the time
spent during an ongoing, concurrent, real-time electrophysiologic monitoring.
2. Time spent in clinical activities, other than those above, should not be billed
under 95940 and/or 95941. The time spent performing or interpreting the
baseline electrophysiologic studies must not be counted as intraoperative
monitoring, but represents separately reportable procedures. "
https://www.aan.com/uploadedFiles/W...overage_Policies/Coverage Policies - IONM.pdf