Regulatory and medical-legal aspects of intraoperative monitoring

Public policies are in place for health care to insure high quality, organized delivery of care to patients. Public policy issues for intraoperative monitoring include billing, coding, reimbursement, staffing, device approval, and liability. Staffing issues include privileging, credentialing, certifying, training, and professionalism. Those staffing processes provide ways that the profession passes judgment on individual's skills, knowledge, abilities, and training relevant to monitoring. These issues,are reviewed here, along with a discussion of the respective roles of physicians and non-physicians in monitoring. Various billing codes for intraoperative monitoring are reviewed along with the circumstances in which they are to be used. Policy on the use of non-approved devices is also presented.