Anesthesia Coding Alert

Caution:  Anesthesia coders should steer clear if your MD provides MAC

Implementing CPT Codes 2006 on Jan. 1 means coding changes across the board, with updates in conscious sedation codes being of special interest to anesthesia and pain management professionals.
 
CPT 2006 eliminates the old conscious sedation codes 99141 (Sedation with or without analgesia [conscious sedation]; intravenous, intramuscular or inhalation) and 99142 (- oral, rectal and/or intranasal). Instead, CPT 2006 includes six new codes that give you more specific options in these cases:

- 99143--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; under 5 years of age, first 30 minutes intra-service time

- 99144--- age 5 years or older, first 30 minutes intra-service time

- +99145--- each additional 15 minutes intra-service time (List separately in addition to code for primary service)

- 99148--Moderate sedation services (other than those services described by codes 00100-01999), provided by a physician other than the health care professional performing the diagnostic or therapeutic service that the sedation supports; under 5 years of age, first 30 minutes intra-service time

- 99149--- age 5 years or older, first 30 minutes intra-service time

- +99150--- each additional 15 minutes intra-service time (List separately in addition to code for primary service).
 
The level of training a person needs to provide moderate sedation (as described in these codes) is different from that for deep sedation, explains Scott Groudine, MD, an Albany, N.Y., anesthesiologist. Individuals can only provide moderate or deep sedation or anesthesia after training to administer the drugs, monitor their effects and rescue patients from deeper levels of sedation than those intended.

New Terminology Helps Explain Code Choice In addition to expanding code choices, CPT 2006 makes a terminology change, replacing the phrase -conscious sedation- with -moderate sedation- in an attempt to describe services more accurately. The new terminology and detailed sedation standards make determining whether you-ll use the codes easier.

-An anesthesiologist does not perform conscious sedation,- Groudine says. -Any moderate or deep sedation administered by an anesthesiologist is considered monitored anesthesia care (MAC). Only professionals with full anesthesia privileges can perform MAC because you must have the ability to convert to general anesthesia during the case if necessary.-

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