Intraoperative Neuromonitoring

[RedNeuro]

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I am curious about the state of IONM. Is it still possible to see patients while simultaneously monitoring? There are many code sets, including the G0453- how will each affect monitoring while doing other tasks? Thank you.

 

[AlternateSome1]

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

 

[AlternateSome1]

Here is a release about the most recent CMS changes, but this isn't the original announcement. It does highlight that the time spent monitoring should be exclusively devoted to monitoring.

http://www.cms.gov/Medicare/Medicar...ysicianFeeSched/Downloads/FAQ-Remote-IONM.pdf

 

[RedNeuro]

Thank you, AlternateSome1!