Wiki Bronch and sedation billing....I need some guidance PLEASE!!!

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reneemohr

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I recently starting working for Pulmonary docs. They do a lot of bronchs, which include sedation. We are having the worst luck getting these sedation codes paid. Does anyone know how to accomplish getting paid for these?? Also, we bill for SO many bronch codes, and no one seems to know the right way to do it. Before I got here, it was all trial and error, but I don't think anyone was keeping track of what got paid and/or denied. (all of our payments/denials are sent to our CBO, and not our office). If anyone has any cheat sheets, or suggestions.....PLEASE let me know!!!
 
Check your CPT code for the symbol

Check your CPT book ... Almost all the bronchoscopy code have a "target" symbol to the left. That means these codes already include moderate sedation, so it cannot be separately billed.

Additionally, all the codes that include moderate (conscious) sedation are listed in Appendix G

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
That does help. However.....the provider doing the sedation is not the provider doing the procedure, so according to the book, we can bill 99149 and 99150. We have lots of claims that have numerous 99150 codes. No one wants to pay for this! I'm not sure how to get these paid, and I'm running out of patience!
 
Procider doing sedation same practice / same specialty?

If the provider who is doing the sedation is in the same practice and of the same specialty s/he is considered the same doctor. Could this be the source of your difficulty?

F Tessa Bartels, CPC, CEMC
 
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