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Ob-Gyn Coding Alert

You Be the Coder:

How to Use Conscious Sedation Codes

Published on Tue Mar 01, 2005

Question: How should I report the new conscious sedation codes? Should I report 99141 (by itself), the procedure 10180, and the HCPCS codes of the drugs the ob-gyn used?


Tennessee Subscriber


Answer: The sequence for the procedure you describe would be 10180-47 (Incision and drainage, complex, postoperative wound infection; anesthesia by surgeon), 99141 (Sedation with or without analgesia [conscious sedation]; intravenous, intramuscular or inhalation), and the J code for the drug the ob-gyn used. Modifier -47 (Anesthesia by surgeon) indicates that the surgeon is performing the anesthesia - in this case the conscious sedation.

Keep in mind that you should use the conscious sedation codes (99141-99142) when the physician performing the surgical procedure is also administering the conscious sedation. Based on CPT coding guidelines, using the conscious sedation codes requires that:
 

  • the sedation be administered by the physician performing the procedure, and
     
  • an independent trained observer is present to assist the physician in monitoring the patient's level of consciousness and physiological status.

    If the procedure meets these criteria, you would separately report the conscious sedation, in addition to the codes for any other procedures performed. No modifier would be required with the 99141 or 99142 codes.

    Note: The NCCI (National Correct Coding Initiative) has bundled conscious sedation procedures into almost all of the surgical procedures because Medicare does not reimburse the surgeon for performing any kind of anesthesia. This rule does not apply to other payers unless they are using the NCCI bundling rules.

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