What is the 3 level protocol for physician supervision during intraoperative monitoring procedures?

Level of supervision and remote monitoring In 2001, the health care financing administration (HCFA) of the USA set a revised 3-level protocol for physician supervision during a diagnostic test: general, direct, and personal supervision (37).

Does Medicare cover intraoperative neuromonitoring?

All cases monitored, remote or those performed in the operating room require the exclusive undivided attention of the monitoring physician for consideration of Medicare coverage. Medicare does not provide for reimbursement of “incident to” care in the hospital setting.

Who can perform intraoperative monitoring?

While a full IONM team consisting of at least four members- an operating surgeon, an anesthesiologist, a neurophysiologist, and a medical technologist trained by a neurophysiologist-is usually necessary to perform IONM, a smaller team may suffice under limited circumstances.

What is involved in intraoperative monitoring?

Intraoperative neuromonitoring (IONM) protects patients by continuously monitoring the central nervous system (the brain, spinal cord, and nerves) when it is at risk during surgery. Depending on the procedure, a variety of tests can be used to measure the nervous system function.

How much does Neuromonitoring cost?

Neuromonitoring was associated with a significant (p = 0.006) overall operative cost ($21,949; with vs. $18,064; without). Of the 47 cases with neuromonitoring; one had abnormal intraoperative EMG activity, which returned to normal by case conclusion.

How do you bill for Neuromonitoring?

Intraoperative neurophysiology monitoring codes 95940 and 95941 are each used to report the total duration of respective time spent providing each service, even if that time is not in a single continuous block.

How is intraoperative neuromonitoring done?

Intraoperative neurophysiologic monitoring is performed using a variety of neurophysiologic techniques, including EEG (electroencephalogram), SSEPs (somatosensory evoked potentials), EMG (electromyography), and transcranial motor evoked potentials (tcMEPs), which are then interpreted by physicians to assess the …

Is Neuromonitoring necessary?

Intraoperative neuromonitoring can provide valuable information for a surgeon who performs complex spine surgery procedures and may prevent injury to a patient. However, according to some spine surgeons, this monitoring tool is not necessary or overly helpful in every spine surgery they perform.