Could any one throw some information on Nitrous oxide used as sedation in Emergency Room. Do we have a separate CPT and HCPCS code to indicate this procedure. Experts opinion please.
Thanks in Advance!
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Tag Archives: conscious
conscious sedation
my scenario: patient is given fentanyl, 50 mcg, IVP and versed, 1mg, IVP @ 0823. a second IVP of both meds (same dosage) @ 1036. I am billing for conscious sedation. Does this constitute 15 minutes plus an additional 8 units of intraservice time, do I need to bill each unit separately (8claim lines) or can I bill one line with 8units and if the meds are given by an RN but the patient is monitored by an MA(attending to the patient) and a physician(performing the procedure), do I bill with cpts 99152/99153, or 99156/99157? (patients are always older then 5yrs) Thanks for any help!
Cardiac Catherizations–93458-26 with moderate conscious sedation Denials
We are billing 93458-26 with 99152 as the documentation is supportive of Moderate Conscious Sedation. 93458 is on the list of CPT codes that 99152 can be billed with. However, for the professional component only should we be billing 99152 in addition to the Cath? We are getting denials from Anthem specifically for these scenarios.
Moderate Conscious Sedation coding
Hello,
Tt’s been almost a year since the implementation of these codes, but I am still unsure of the guidelines. We bill 99152 only (we don’t see kids). We billed 99153 at the beginning but then found out that it’s a PC/TC code. The time is not an issue. What I’m not sure is the pre-service work that’s required. In the book, there are 12 bullet points of pre-service work. Most of the times my doctors have them all in the H&P and Pre-Sedation evaluation. Once in a while they miss the Review of the patient’s previous experiences with sedation complications (bullet #2) and Family hx of sedation complications (bullet #3), when this happens, I don’t bill.
My question: Are they required to have every one of those 12 bullet points reviewed to bill 99152 (and other MCS codes)? Their H&P contains past medical and family histories as well, is this enough or do they have to specifically review bullet #2 and #3 separately. (page 676 on AMA CPT Book 2017)
I have been very strict with them… (for 1/4 RVU!!!), but when I read the internet, I don’t seem to see any explanation. Just want to know what auditors think and how others do at their org.
Tt’s been almost a year since the implementation of these codes, but I am still unsure of the guidelines. We bill 99152 only (we don’t see kids). We billed 99153 at the beginning but then found out that it’s a PC/TC code. The time is not an issue. What I’m not sure is the pre-service work that’s required. In the book, there are 12 bullet points of pre-service work. Most of the times my doctors have them all in the H&P and Pre-Sedation evaluation. Once in a while they miss the Review of the patient’s previous experiences with sedation complications (bullet #2) and Family hx of sedation complications (bullet #3), when this happens, I don’t bill.
My question: Are they required to have every one of those 12 bullet points reviewed to bill 99152 (and other MCS codes)? Their H&P contains past medical and family histories as well, is this enough or do they have to specifically review bullet #2 and #3 separately. (page 676 on AMA CPT Book 2017)
I have been very strict with them… (for 1/4 RVU!!!), but when I read the internet, I don’t seem to see any explanation. Just want to know what auditors think and how others do at their org.
Thanks a bunch!
Conscious Sedation
Has anyone found documentation clarifying the maximum (if there is one) of time to bill for CS? Last months magazine had a graph in it that said 83 minutes OR LONGER would be 99152 and 99153 X 5 but I’d like some type of concrete policy to back me up.
Thanks!
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.