Billing and Coding: Monitored Anesthesia Care

Monitored Anesthesia Care (MAC) may be separately billable when one or more listed supporting diagnoses (e.g., F91.9, G97.81, T81.9XXA, T88.8XXA, F79) are documented and matched to the anesthesia/CPT/HCPCS procedure, or when modifiers G8 or G9 apply for complex procedures or severe cardiopulmonary disease, respectively. Anesthesia procedures usually included in the global surgical fee are not separately billable unless medical necessity is documented; all documentation (legible records, provider signature, ICD‑10 and CPT/HCPCS support) must be maintained and available to the contractor.

"Monitored Anesthesia Care (MAC) is medically necessary when the patient has one or more documented diagnoses listed as supporting medical necessity (e."

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