Skip to content
CPCSTUDY COURSEMy progress

CPC STUDY COURSE · 2026 EDITION

Personally performed anesthesia with a precise handoff time

Read an original fictional chart, identify the supported facts, and explain your coding workflow.

Chart gym · Original fictional record

Service date: 2026-09-08 · Professional outpatient claim; Original Medicare unless stated otherwise

Use your code books and write your reasoning before opening the walkthrough. This exercise contains no real patient information.

Surgical reason

Fictional patient Morgan Hale, age 52, undergoes a scheduled laparoscopic cholecystectomy for provider-confirmed gallbladder stones without cholecystitis or obstruction. The completed surgical diagnosis remains unchanged. The worksheet concerns the separate anesthesia professional’s service, not the surgeon’s procedure claim.

Preanesthesia evaluation

The anesthesiologist performs the preanesthesia assessment before the continuous anesthesia interval. The patient has controlled hypertension, no substantial functional limitation and no other documented systemic disease. The anesthesiologist records ASA physical status II. The case is elective, without an emergency designation or separately documented qualifying circumstance.

Professional role

One anesthesiologist personally provides the entire anesthesia service. There is no CRNA, anesthesiologist assistant, trainee or overlapping medically directed case. The anesthesiologist prepares the patient for induction in the operating area at 08:10 and remains in continuous personal attendance through the documented handoff.

Time record

The operation begins at 08:25 and ends at 09:12. The patient reaches recovery and is safely placed under postoperative supervision at 09:27, when the anesthesiologist’s continuous attendance ends. The earlier preanesthesia evaluation began at 07:45. There is no interrupted or overlapping anesthesia interval to subtract or combine.

Calculation worksheet

Use the licensed anesthesia entry for the actual procedure and site. For arithmetic practice only, assume an assigned base value of 6 units; this is a supplied exercise value, not a published value for a particular entry. Apply Medicare’s actual-minutes conversion to the eligible interval and identify the professional role. Do not use skin-to-skin surgical time or add the preanesthesia evaluation to the timed interval.

Your coding worksheet

  1. Identify the reason for this encounter and the supported diagnoses.
  2. List the services actually completed and the applicable code sets.
  3. Use your books to select final codes, units and any supported modifiers.
  4. Sequence the diagnoses and explain the relevant instruction.
  5. Review included work and any separate coverage question. Explain why the strongest alternative does not fit.

In your notebook, record the supported facts, your index route, the instructions you checked, and any missing detail that limits your answer.

Write your answer

Use only this fictional record. Your entries stay on this page and disappear when you leave or reload. Do not enter real patient information.

Compare with the worked explanation
  1. The surgical diagnosis is K80.20 for the documented gallbladder calculus without cholecystitis or obstruction. Verify the Index and Tabular route rather than adding an unconfirmed inflammatory or obstructive condition.
  2. Choose the current anesthesia procedure entry from the actual operation and anatomical site. The surgeon’s procedure entry is not automatically the anesthesia entry. The supplied base value is only for the arithmetic exercise.
  3. Continuous anesthesia time is 08:10–09:27, or 77 minutes. It includes the defined preparation and safe-supervision interval, not merely 47 minutes of surgery, and excludes the earlier separate evaluation.
  4. Under the cited Medicare method, 77 divided by 15 is 5.133… time units, rounded to one decimal place: 5.1. Adding the exercise’s 6 base units gives 11.1 before any applicable fee calculation. Actual reported minutes remain 77.
  5. AA matches the stated personally performed anesthesiologist role. Do not substitute medical-direction modifiers when no such relationship is documented. Physical status is a separate fact from the provider-role modifier.
  6. The anesthesiologist documents ASA II. Preserve that assessment rather than assigning a more severe class from age or from the mere fact of surgery. Do not invent emergency or qualifying-circumstance work. Payment treatment of physical status and other factors still requires payer-specific review.

Reference sections: NCCI II; claims12 50; ASA classification; K80.20

Practice the linked chart questions

Review the lesson

Sources

  1. CMS — Medicare NCCI 2026 Chapter II: Anesthesia Services. 2026. Accessed 2026-09-10.
  2. CMS — Medicare Claims Processing Manual, Chapter 12: Physicians and Nonphysician Practitioners. 2026 service window; cited current manual sections. Accessed 2026-09-10.
  3. American Society of Anesthesiologists — ASA Statement on ASA Physical Status Classification System. Amended October 15, 2025; Anesthesiology Open January 2026. Accessed 2026-09-10.
  4. CDC NCHS — ICD-10-CM April1,2026 Index and Tabular XML. April1–September30,2026. Accessed 2026-09-12.

Return to the chart gym →