in room breaking policy

We are considering experimenting at making a change to our "breaking policy", where Anesthetists would be able to break a resident. We are looking for some feedback on what the current standard billing practice is when a case with a resident is given a short break (15 min or 30min) by an Anesthetist and the case was a Medicare patient. To our knowledge there are no policies that address this type of scheduling and how the time should be billed for the anesthetist for short duration breaks.  At our facility we bill Anesthetists (CRNAs/AAs) under Medical direction only.  How would you bill the following: An Anesthesiologist had two rooms running concurrently with residents.  On one of the cases the resident was present for the majority of the time but was given a short break (30min or less) by an Anesthetist. The payer is Medicare.  
      1)      Anesthesiologist is billed with an AA, even though the Anesthetist was on the case for a short duration since the majority of the time the resident was on the case OR 2)      Anesthesiologist is billed with the QK (or QY) reporting total minutes for the case and the Anesthetist is billed with a QX reporting only the time that he/she was on the case (i.e. 15 minutes) 3)      OR do you only allow like providers to break like providers?

                      4)      Or another manner that isn’t listed here

thank you so much for any input.

Beth


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