Members of the ASA Committee on Economics would like to clarify language that was printed in the article “Non-Operating Room Anesthesia (NORA): Humbug If NOT Careful” in the September 2019 ASA Monitor. There was concern that the statement highlighted below gives the impression a proceduralist can use QZ billing to bill for a concurrent anesthesia service, which is misleading. The following is excerpted from the article:

Some basic tenets are as follows:

The committee would like to clarify that statement in the following way:

It is important to clarify that there are situations where the critical care anesthesiologist is also the proceduralist. For example, a percutaneous tracheostomy performed by an intensivist (the critical care anesthesiologist). In this case, the tracheostomy would be reported as a procedure separate from critical care time. However, it must be clarified that in this scenario, the anesthesiologist may not direct or supervise a non-physician...

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