Wiki 99144 Anesthesia in ASC

[teddydynia]

Q: I was told that this is not legal for the physician to provide conscious sedation monitoring & perform the procedure on patients in certain states. Is this true for WA? Or I being misinformed by ARNP?

 

[blueyes301]

I too am in Washington and work for an ASC and we do lots of conscious sedation. As the ASC is providing the medication and the nursing staff that the physician directs to do the CS; the physician legally should not bill 91444. By doing so you are double billing the patient for the anesthesia (CS). Physicians can legally peform CS in an ASC as long as the have as their ACLS is current and they are credentialed to do so.

 

[dwaldman]

Wouldn't CPTs 99144-99145 be bundled into the surgical/injection procedure for the ASC for Medicare so is the carrier really being double billed in terms what they are going to pay separately. If the physician performing the procedure is also providing conscious sedation with a trainer observer, there is a service provided by the physician that seems like he is entitled to reimburse in a setting other than non-facility. When I looked at WPS Medicare's physician fee schedule they have a non-facility and facility separate fee for 99144 so wouldn't this account for his staff versus the facility's staff conducting as the trainer observer and who is taking on the cost of the meds?