Pulmonology Coding Alert

Question: If a physician who administers conscious sedation while another physician performs an emergency procedure, can he bill critical care for the time instead of conscious sedation? 99291or 99149?Michigan SubscriberAnswer: A physician should only report the code that represents the services provided. CCI edits bundle moderate (conscious) sedation into many procedures when administered by the performing physician (or two physicians of the same specialty in the same provider group). Per CPT, moderate sedation is a drug induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. Patients require no intervention to maintain an airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained. Moderate sedation does not include minimal sedation (anxiolysis), deep sedation or monitored anesthesia care (00100-01999).When providing moderate sedation, include the following services and do not report separately:Assessment of the patient (not included in intraservice time); Establishment [...]