Radiology Coding Alert

Answer: The radiologist would report codes 99141 or 99142, and the facility would bill for the room, supplies and nursing care.

Codes 99141 and 99142 were created to allow for sedation with or without analgesia to be reported by physicians other than anesthesiologists or nurse anesthetists. Specifically, these two codes should be used to report conscious sedation when administered by the same physician who is performing a procedure. (If a physician other than the doctor performing the procedure administered the anesthesia, it would need to be billed using a code from the anesthesia section of CPT.)

Using codes 99141 and 99142 requires the presence of an independent trained observer to assist the physician in monitoring the patients physiological status and level of consciousness. The definition of independent trained observer indicates that the designated individual, other than the performing physician, should be responsible for monitoring the patient during the procedures performed with sedation/analgesia. This individual should be able to recognize complications and be capable of establishing a patient airway and positive pressure ventilation as well as summon additional assistance. Advanced life-support skills should be immediately available. Therefore, a registered nurse administering conscious sedation under the supervision of a radiologist during invasive procedures would be considered the independent trained observer."