Charging for TIVA for endoscopy

[orangele]

My question relates to billing for TIVA (total IV Anesthesia) for cases which I have always billed as MAC (monitored anesthesia care).  In reality I do often believe that a significant percentage of patients do slip into deep sedation or perhaps deeper when I do such cases (endoscopies/I+D's), and perhaps even a state of general anesthesia on occassion.   

This question arises since I see that the CRNA's that work independently of me, charge for TIVA routinely.  This of course allows reimbursement for cases that if billed as MAC would not be reimbursed.  Up to this point, I have continued to bill as MAC, even when I know this will mean I am not reimbursed.  I am frustrated by the fact that the government would have such a payment system, and believe that the system encourages people to bill for TIVA.

[dejswa]

What is MAC?   All anesthesia care is MAC.

But for billing, all anesthesia care is GA. Period.

You get paid for your anesthesia time with the patient.  Don't use a term like 'MAC' which makes absolutely no sense and might give someone an excuse not to pay you.