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Click here for more sample CPC practice exam questions and answers with full rationale

no drugs administered, is this still MAC?

Per ASA statement of "Position on Monitored Anesthesia Care", During monitored anesthesia care, the anesthesiologist provides or medically directs a number of specific services, including but not limited to:
1. Diagnosis and treatment of clinical problems that occur during the procedure
2. Support of vital functions
3. Administration of sedatives, analgesics, hypnotics, anesthetic agents or other medications as necessary for patient safety
4. Psychological support and physical comfort
5. Provision of other medical services as needed to complete the procedure safely.

There was no anesthetic agent administered.
Does this still qualify for MAC?

Thank you.

Medical Billing and Coding Forum

Nurse visit for a TB test administered

Hello..

I have a nurse visit where a TB test was the only thing done. There were no vitals documented, only the documentation of the TB test being given with instructions to come back 2 days later for the test to be read. How would you code this? A person in my billing department wants me to put E/M of 99211. Would that be appropriate? Thanks

Medical Billing and Coding Forum

New CPT codes 00811 and 00812 for Anesthesia administered during colonoscopy procedures


Anesthesia services furnished in conjunction with and in support of a screening colonoscopy are reported with CPT code 00812 (Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy). CPT Code 00812 will be added as part of January 1, 2018 HCPCS update. Effective for claims with dates of service on or after January 1, 2018, Medicare will pay claim lines with new CPT code 00812 and waive the deductible and coinsurance. 

When a screening colonoscopy becomes a diagnostic colonoscopy, anesthesia services are reported with CPT code 00811 (Anesthesia for lower intestinal endoscopic procedures, endoscopy introduced distal to duodenum; not otherwise specified) and with the PT modifier. CPT code 00811 will be added as part of the January 1, 2018 HCPCS update. Effective for claims with dates of service on or after January 1, 2018, Medicare will pay claim lines with new CPT code 00811 and waive only the deductible when submitted with the PT modifier.


Coding Ahead

Moderate (conscious) Sedation ADMINISTERED and monitored by hospital employed nurse

I am trying to obtain clarification of when moderate sedation can be reported by the same physician performing the diagnostic/therapeutic service when performed is a hospital setting. Is it appropriate to bill 99151-99152 if the moderate sedation if it is ordered by the physician, but is ADMINISTERED by the hospital employed nurse who also monitors the patient, or is it expected that the physician performing the diagnostic/therapeutic service order and personally administer the moderate sedation in order to bill for the physician’s work? I can not seem to find any solid publication that clarifies this scenario. Any guidance is much appreciated.

Medical Billing and Coding Forum