Wiki Coding deep sedation for non-Anesthesiologist

[PaperPusher59]

Does anybody know what the coding guidelines would be for a pediatric critical care hospitalist (physician) performing deep sedation would be? The major payer source, of course, is Medicaid. Since he is not an anesthesiologist (is a Pediatric Intensivist), should he be coding from the 00100-01999 series or 99143-99150? The argument presented is that because they don't have specific codes for deep sedation, and the guidelines in the 99143-99150 specifically state that those codes are not used for deep sedation, that the only choice is monitored anesthesia care 00100-01999. Thanks so much for anybody's help with this!

 

[jkyles]

Hi there, you're right about moderate sedation - it should not be reported for deep sedation (or vice versa).

Assuming the doctor is qualified to perform anesthesia, the payer permits anesthesia services by non-anesthesia providers, and the service meets all other requirements for an anesthesia service, you would report the appropriate anesthesia code and follow the rules for time, base units etc.

Keep in mind that monitored anesthesia care describes a specific set of services, but is still reported with anesthesia codes.

Here's the continuum of depth of sedation from the American Society of Anesthesiologists

https://www.asahq.org/standards-and-guidelines/continuum-of-depth-of-sedation-definition-of-general-anesthesia-and-levels-of-sedationanalgesia

Here's the ASA's statement on granting privileges to perform deep sedation by non-anesthesiologist doctors. The document itself isn't a law that everyone must follow, but the ASA is the authoritative specialty society so it is safe to assume that laws and rules are based on the document.
https://www.asahq.org/standards-and...p-sedation-to-non-anesthesiologist-physicians
https://www.asahq.org/standards-and...p-sedation-to-non-anesthesiologist-physicians