Pediatric Coding Alert

 

New York Subscriber

 

Answer: Conscious sedation codes 99141 (sedation with or without analgesia [conscious sedation]; intravenous, intramuscular or inhalation) and 99142 (... oral, rectal and/or intranasal) are written specifically for use by the physician performing the primary procedure, not for use by a second physician. You were denied payment when you performed the procedure in the hospital precisely because you performed it for another physician.

 

A nurse or other health professional, but not necessarily a doctor, must be present to assist and monitor vital signs during administration of conscious sedation. 

 

A typical procedure in which a pediatrician might use conscious sedation codes is repair for a facial laceration (12011). Although an adult might not need sedation for this, a small child would -- simply because the child might not sit still. 

 

If you perform a laceration repair and also administer the sedation, you can bill 99141 or 99142 in addition to the 12011.