Question: Should the time spent placing nerve blocks for postoperative pain control, spinals, arterial lines, etc, be deducted from anesthesia start and stop times? Is there a difference between the arterial line, etc, being placed prior to induction or after with regards to discounting this ‘placement’ time?
Answer: The Anesthesia guidelines in the CPT codebook indicate that placement of monitoring devices such as central venous lines, arterial lines, and Swan Ganz catheters are separately reportable from an anesthesia service. Placement of those monitoring devices have no time associated with them, but can be billed as separate, no-time services.
If a nerve block or epidural is performed for the purpose of postoperative pain management and not as part of the anesthesia for the surgical procedure, then it, too, is reported separately. When these procedures are performed before the start of anesthesia time, the time spent on them should not be added to the reported anesthesia time because they are separate and distinct from the anesthesia service. If the procedure is performed after induction of the primary anesthetic, it is not necessary to deduct time spent on the procedure from reported anesthesia time.