Supervise CRNA and perform pain procedures at same time?

[dizzy1127]

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Can I supervise a CRNA and perform pain procedures at the same time? I'm having a hard time finding a separate anesthesiologist to help me with my pain procedure sedation, or is this not allowed?

Thanks.

 

[jwk]

IMHO - no. You are the sole practitioner in a wholly separate billable procedure. That would be like you performing two simultaneous anesthetics at the same time (not directing or supervising - performing). I think this is different than doing blocks/lines while another case is going on.

 

[facted]

This is a no.

 

[deleted126335]

Depends on how you define "pain procedure". Doing a nerve block or an epidural in preop for a surgical patient or a labor epidural while medically directing is OK.

Other than that, you cannot bill medical direction (QK) while doing pain procedures.

Billing Medical Supervision (AD) MAY be OK. I think so but not sure. Billing (QZ) CRNA only case while supervising to satisfy state law or institutional policy MAY be OK. I think so but not sure.

 

[AdmiralChz]

Expressly forbidden at our practice, in fact when we go on pain consults we can’t be supervising at the time for those so we have to go through some hoops. We don’t do QZ modifier ever, though.

 

[somedumbDO]

Labor epidural or PNB while supervising/directing yes. Pain procedure: lesi, cervical etc HARD NO.

 

[deleted126335]

Labor epidural or PNB while supervising/directing yes. Pain procedure: lesi, cervical etc HARD NO.

Again this is a definite “NO” while medically directing. It MIGHT be ok while medically supervising or billing QZ and “supervising” to meet Institutional requirements. You need a compliance attorney to look at it. Also your med map carrier and you need to know exactly how you are billing.

 

[cchoukal]

I think the OP is asking if he can supervise the nurse anesthetist who is anesthetizing his pain patient. How is this different from the surgeon being the responsible physician for a solo nurse anesthetist doing his case? He may not be able to bill for, but that is a different matter.

 

[AdmiralChz]

I think the OP is asking if he can supervise the nurse anesthetist who is anesthetizing his pain patient. How is this different from the surgeon being the responsible physician for a solo nurse anesthetist doing his case? He may not be able to bill for, but that is a different matter.

Definitely can’t bill for it, at least conventionally. Same thing for cardioversions - the anesthesiologist can’t push the button (if they want to bill for it), the cards guy has to.

 

[deleted126335]

Definitely can’t bill for it, at least conventionally. Same thing for cardioversions - the anesthesiologist can’t push the button (if they want to bill for it), the cards guy has to.

Maybe the CRNA can bill QZ, thus an anesthesia fee can be collected. It would go to the CRNA or their employer.

 

[Southpaw]

Can I supervise a CRNA and perform pain procedures at the same time? I'm having a hard time finding a separate anesthesiologist to help me with my pain procedure sedation, or is this not allowed?

Thanks.

Why do you need sedation for routine pain procedures? Not the norm in areas I've worked in. I'm trying to decide if your question is really 'Can I profit off a CRNA while I perform pain procedures?' (like the world of GI) but that's not what you outright asked.

 

[Twiggidy]

It seems like you could "supervise" the CRNA but just not bill for the sedation. Isn't that what some GIs in the sticks do?

 

[dmk5n]

Some pain centers bill out anesthesia like GI docs do...e.g.
Pain practice bills out the anesthesia, salaries the CRNA at locums rates or whatever, keeps the difference.
And of the course, the points for the billing service. $$$