Anesthesia Coding Alert

Question: An ASC staff nurse administered anesthesia for a 47-yearold patient's epidural steroid injection. Our anesthesiologist supervised the nurse and provided sedation. The ASC bills for the nurse; how do I report the anesthesiologist's supervision if I can't enter the nurse in our billing system?

Minnesota Subscriber

Answer: Case circumstances seem to fall under the category of conscious sedation. If so, one provider administers/oversees the sedation process while a nurse or other "trained observer" monitors the patient. Report 99149 (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; age 5 years or older, first 30 minutes intra-service time).

Here's why: The nurse and your anesthesiologist worked as a team on the procedure. Consider the nurse as the health care professional performing the service -- she administered the steroid injection. Your physician provided the necessary sedation but didn't complete the therapeutic service.