Anesthesia Coding Alert

Reader Questions:

Reporting MAC During GI Procedures

Question: Our state board recently advised that a CRNA or anesthesiologist must administer and monitor Propofol during colonoscopy, EGD and ERCP procedures in digestive services. Can our physician bill for these services and be reimbursed? If so, what code should I report? Iowa Subscriber Answer: If your state board has a policy regarding anesthesia during these procedures, you need to report your physician's work. Submit the appropriate sedation code, depending on the patient's age and the length of your provider's service: 99148 (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; younger than 5 years of age, first 30 minutes intra-service time), 99149 (... age 5 years or older, first 30 minutes intra-service time) and +99150 (... each additional 15 minutes intra-service time [list separately in addition to code for primary service]). To learn about your physician's potential reimbursement, check your local payer's guidelines or talk with your representative.
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