How To Use HCPCS Code G9362

HCPCS code G9362 describes the duration of monitored anesthesia care (MAC) or peripheral nerve block (PNB) without the use of general anesthesia during an applicable procedure that lasts for 60 minutes or longer, as documented in the anesthesia record.

1. What is HCPCS G9362?

HCPCS code G9362 is used to identify the duration of monitored anesthesia care (MAC) or peripheral nerve block (PNB) without the use of general anesthesia during a procedure that lasts for 60 minutes or longer. This code is specifically used to document the length of time anesthesia care or peripheral nerve block is provided without the need for general anesthesia.

2. Official Description

The official description of HCPCS code G9362 is “Duration of monitored anesthesia care (MAC) or peripheral nerve block (PNB) without the use of general anesthesia during an applicable procedure 60 minutes or longer, as documented in the anesthesia record.” The short description for this code is “MAC or PNB without genanes >60m.”

3. Procedure

1. The provider administers monitored anesthesia care (MAC) or performs a peripheral nerve block (PNB) without the use of general anesthesia.
2. The anesthesia care or peripheral nerve block is provided during an applicable procedure that lasts for 60 minutes or longer.
3. The duration of the MAC or PNB is documented in the anesthesia record.

4. When to use HCPCS code G9362

HCPCS code G9362 should be used when the provider administers monitored anesthesia care (MAC) or performs a peripheral nerve block (PNB) without the use of general anesthesia during a procedure that lasts for 60 minutes or longer. It is important to ensure that the duration of the MAC or PNB is accurately documented in the anesthesia record.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9362, healthcare providers need to ensure that the anesthesia record clearly documents the duration of the monitored anesthesia care (MAC) or peripheral nerve block (PNB) without the use of general anesthesia. This documentation is crucial for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G9362 was added to the Healthcare Common Procedure Coding System on January 1, 2015. It has a termination date of December 31, 2015. No maintenance actions have been taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code G9362 is not separately priced by Medicare or other insurers. It falls under the pricing indicator code 00, which means the service is not separately priced by Part B. This code may be bundled or not covered by insurance, depending on the specific circumstances and policies of the payer.

8. Examples

Here are five examples of when HCPCS code G9362 should be billed:

1. A patient undergoes a surgical procedure that requires monitored anesthesia care (MAC) for 90 minutes. The anesthesia record clearly documents the duration of the MAC as 90 minutes.
2. A patient receives a peripheral nerve block (PNB) for pain management during a procedure that lasts for 120 minutes. The anesthesia record indicates that the PNB was administered for the entire duration of the procedure.
3. During a lengthy surgical procedure lasting 180 minutes, the patient receives monitored anesthesia care (MAC) without the use of general anesthesia. The anesthesia record accurately documents the duration of the MAC as 180 minutes.
4. A patient undergoes a procedure that requires a peripheral nerve block (PNB) for 75 minutes. The anesthesia record clearly indicates that the PNB was provided for the entire duration of the procedure.
5. During a complex surgical procedure lasting 150 minutes, the patient receives monitored anesthesia care (MAC) without the use of general anesthesia. The anesthesia record accurately documents the duration of the MAC as 150 minutes.