AMCI Mini - How to Calculate Anesthesia Time and Payments?

this is an AMCI mini by Mrs J in

partnership with

aapc our question for today how to

calculate the anesthesia time well I'm

going to show

you well when you're calculating the

anesthesia time you have to know some

guidelines and these guidelines you can

find on page 54 of your

2016 um CPT

manual the first is the time begins when

the anesthesiologist begins to prepare

the patient and for more

clarification that is when that patient

is in the o or

some some place that's that's comparable

so they have to be in the o or in a

comparable place and your key word is

anesthesiologist so the anesthesiologist

or nurse anesthetist begins to prepare

the patient and this time ends when the

patient is handed over and out of the

care of the anesthesiologist so when

they're handed over to recovery the

recovery nurse that's a good

indicator here's another um um this is

every 15 minutes equals one unit of time

that's another guideline that you have

to follow every 15 minutes equals one

unit of time here is a um image of the

time reporting guideline for when

anesthesia time begins and ends so it

there it is and it's on your page 54 if

you're looking at the

2016 CPT so

remember okay let's begin with a

scenario a pre-anesthesia assessment was

performed and signed at 10:21

a.m. anesthesia start time is reported

as 12:26 p.m. and the surgery began at

12:37 p.m. the surgery finished at 1512

p.m. and the patient was turned over to

Pac you at

1526 p.m. which is reported as the

anesthesia time and what is the

anesthesia time reported okay I did not

come up with this question but it sounds

like they're asking what is the

anesthesia time so let's take a quick

peek let's look at the

scenario no I don't want to look at the

scenario I want to ref reference my

guideline so let me look at this

guideline the guideline is time begins

when the anesthesiologist begins to

prepare the patient and ends when the

patient is handed over and out of the

care of the

anesthesiologist all right that's pretty

direct so let's go ahead and see when

the anesthesia time began um it says

that a pre-anesthesia assessment was

performed at 10:21 well that's good

information however we can assume a lot

but the the biggest thing that we can

assume or know is that it doesn't tell

us if the

anesthesiologist did anything so anyone

could have done it so therefore 10:21 is

not our start time but the scenario

tells you anesthesia start time is

reported is at

12:26 so the scenario is telling us the

start time that is indeed our start time

12:26 so a has a start time of

1021 and D has a start time of

1237 so both are

eliminated now we need to know the end

time again the end time is when the

patient is handed over and out of the

care of the

anesthesiologist all right the surgery

finish time is

1512 that's not what we're looking for

we're not looking for the the surgery

time we're looking for when the patient

is turned over or handed over and the

patient was turned over to pack you at

1526 indeed

1526 is our anesthesia end time so B is

correct the begin time is 12:26 and the

end time is

1526 okay so let's so that was pretty

simple so let's look at a scenario where

we have have to calculate the

anesthesia time unit all right so that's

what most people want to know how do you

calculate the time units well we're

going to look at this scenario and we're

going to change a few things and not

make it so neat okay I'm going to show

you how to calculate time using my

circle quadrants no I did not come up

with this I think I learned this maybe

20 years ago when I was working working

as a payer for a um

large

payer okay let's

go okay here it's

and if we know that anesthesia time took

3 hours and 27 minutes and we've got to

figure out the number of

units I say use

this

circled quadrant visual yes go ahead and

draw a circle and put a plus in the

middle because each

quadrant 1 2 3 4 equals 15 minutes and

if you have if you count them up that's

going to equal 60 and therefore this is

going to represent 1 hour and also each

quadrant equals one unit so if we know

that 3 hours and 27 minutes is our time

let's go ahead and shade in we know 3

hours this is 1 hour that's 2 hours and

this is three hours oh that's a cute

little visual so let's go ahead and

shade them in because we have to know

exactly the number

of units so everything that we're

shading in each each quadrant equals

one anesthesia time unit

all right so we know we got three hours

so let me

quickly oh never been a good drawer but

I'm doing my best as long as it has red

in

it we count

it so we're going to count our three in

a

second there's our three hours one two

three so what we have to do is count the

units within those three hours there's

four one 2 3 four there's another four

five 6 7 8 and here's another four 1

excuse me 9 10 11 12 so at least that's

12 units but don't forget we got to

calculate the quadrants for 27 minutes

and how you do it we know this is

15 and we know this is a maximum of

30 all right so 27 Falls right in here

so so we know we have 12 here 13

14 14 units of time so anesthesia time

if it was 3 hours and 27 minutes it is

it equals to 14 units of anesthesia

time and don't forget each quadrant

equals 15 15 minutes 15 um 15 minutes of

time equals 1 unit let's try it

again okay anesthesia time took 2 hours

and 33 minutes we know because we've got

2 hours that we need at least two

circled quadrants and we also have 33

minutes and we know we need an

additional one so I'm just going to put

my three quadrants out circled quad to

say that okay and I know each quadrant

equals 15 minutes and that equals one

unit of time so the

first we got to figure out the two hours

let's go ahead and shade in two

hours that's one let's shade in the

second

hour that's two now the third one is

we've got to shade in the 15 minutes

remember we've got 33 minutes to shade

in and then we're going to shade the

next quadrant that's up to 30 minutes so

now we're moving on into this next

quadrant for those three extra

minutes okay so this is not an hour so

ignore that so let's count our units 1 2

3 4 5 6 7 8 9 10 11 there you go it's

11 time

units okay let's take a look at

something else I want to look at it from

a different

perspective let's say the scenario just

gives you the minutes some people have a

little difficulty converting and that's

the reason why calculators manual

calculators are permitted on the CPC

exam um let's say they give you only the

minutes

what you have to do is simply divide it

by 60 and if you divide your anesthesia

time minutes by

60 let's say your anesthesia time is 120

Minutes you divide it by 60 that equals

2 hours and that equals 8 units so I

would do my circle quadrants in for you