Two eligible blocks with a documented interruption

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

Chart gym · Original fictional record

Service date: 2026-09-09 · Medicare anesthesia professional service

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

Patient and setting

Original fictional record. Paula Marsh, age 76, attends an outpatient center for a right-eye cataract procedure on September 9, 2026. The professional anesthesia claim is for Original Medicare. The anesthesiologist’s signed plan and actual care log are available with the surgeon’s completed report.

First anesthesia block

10:00–10:20: the anesthesiologist provides twenty minutes of continuous eligible anesthesia care around the regional eye block. At 10:20 the clinician documents that anesthesia-practitioner care stops. The next twenty-five minutes require no anesthesia-practitioner monitoring, according to the signed note, and none is furnished. This is an explicit fact of the fictional record, not a monitoring decision for the coder to make.

Resumed anesthesia care

At 10:45 the anesthesiologist resumes continuous eligible anesthesia care for the cataract procedure. The surgical work occurs within this second interval. Anesthesia care continues through completion and safe transfer at 11:25. The clinician records no excluded activity or other-patient service during those forty minutes.

Reconciliation discrepancy

The scheduling system reports eighty-five elapsed minutes from 10:00 to 11:25. The signed anesthesia record instead distinguishes two care blocks and the unmonitored interruption. There is no third eligible interval. The routine earlier assessment is separate from this log and is not included in either care block.

Coding task

Reconcile the elapsed scheduling duration with the actual eligible care. State what clinical documentation would change the treatment of the interruption. Confirm the final service entry and practitioner role separately in the authorized reference; do not use the scheduling total as proof of continuously furnished anesthesia.

Your coding worksheet

List the included and excluded intervals.
Calculate the supported total.
Explain why elapsed time and eligible time differ.
Describe which changed documentation would require reassessment.

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

Compare with the worked explanation

Include twenty and forty minutes; exclude the supplied twenty-five-minute unmonitored interval.
The supported eligible total is sixty minutes.
Eighty-five minutes is elapsed time and includes the expressly excluded interruption.
If the record instead established required continuous anesthesia monitoring during the interval, reassess under the full rule rather than automatically using this exercise’s exclusion.

Reference sections: B.2

Practice the linked chart questions