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deep sedation,conscious sedation, etc


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Please help clarify....providers wish to code conscious sedation with a modifier. What modifier would you use?

Does anyone code deep sedation and how do you do this?


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deep sedation,conscious sedation

There's a difference in the level of sedation between "Conscious Sedation" aka: Moderate Sedation and Monitored Anesthesia Care.

Monitored Anesthesia Care is a deeper level, and when the patient receives this, we use the -QS modifier to tell the carriers that this is Monitored Anesthesia Care (MAC).

Conscious Sedation is a lighter level, often the patient may be very aware but very relaxed, not nearly as "drowsy" as those receiving MAC. I've even seen patients continue talking while certain procedures were done, but the level of sedation was enough to keep them from experiencing pain.

When Conscious Sedation is used, we do *not* use any modifier at all; in fact, we choose those codes from CPT - 9914x that are appropriate for the situation. Some are paid by the carriers, some are not. Don't forget that some procedures already have the sedation included in the RVU.

Be very careful to not mix up the different kinds of sedation so that you can report these anesthesia services correctly.

To help, here's a great table on the levels of sedation from ASA: http://www.asahq.org/publicationsAndServices/standards/20.pdf

Leslie Johnson, CPC