Pediatric Coding Alert

Question: Our pediatrician spent two hours providing rectal conscious sedation with Brevital for a patient undergoing a magnetic resonance imaging (MRI) of the head. How can we get paid for this?

New Mexico Subscriber

Answer: In this situation the pediatrician can use only the conscious sedation codes (99141, 99142). Although CPT directs coders to the anesthesia codes, if the sedation with or without analgesia (conscious sedation) is administered in support of a procedure provided by another physician, no codes in the anesthesia portion of CPT accurately describe rectal conscious sedation with Brevital.

Conscious sedation is normally provided by the same physician performing the primary procedure. CPT specifies that an independent trained observer be present to assist the physician in monitoring the patients level of consciousness and physiological status, but does not require that the observer be another physician.