Wake Up Your Reimbursement By Capturing Sedation Pay
Posted on 09. Feb, 2009 by admin in Hot Coding Topics
Reporting CS with a ‘targeted’ service puts a denial bull’s eye on your claim.
If you’re not coding for the moderate sedation (also known as conscious sedation or CS) your surgeon performs during a procedure, you’re potentially costing your practice money for every procedure he uses moderate sedation for. How much depends on your payer.
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“Coders shouldn’t assume they cannot report the sedation,” says Lisa Center, CPC, physician billing certified professional coder with Mt. Carmel Regional Medical Center in Pittsburg, Kan. “They need to check the codes to see if the code includes sedation and, depending on the setting, they might be able to use one of the conscious sedation codes.” Make sure you’re not losing precious reimbursement with these expert tips on moderate sedation coding.Check the Number of Providers
The moderate sedation codes are divided into two sections based on who is providing the moderate sedation:
• The physician performing the procedure: 99143-99145 (Moderate sedation services [other than those services described by codes 00100-01999] provided by the same physician performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status …)
• A physician other than the provider performing the procedure: 99148-99150 (Moderate sedation services [other than those services described by codes 00100-01999], provided by a physician other than the healthcare professional performing the diagnostic or therapeutic service that the sedation supports …).
“Both sets of codes are then further broken down based on the age of the patient and incremental time,” says Maggie M. Mac, CMM, CPC, CMSCS, consulting manager for Pershing, Yoakley and Associates in Clearwater, Fla....
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One Response to “Wake Up Your Reimbursement By Capturing Sedation Pay”
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Jim King
19. Oct, 2009
What codes are needed for anesthesia providers to be reimbursed for moderate sedation during colonoscopies?
I am told that certain codes are needed to bill.
Thank you,
Jim King, CRNA (Nurse Anesthetist)