Wiki New 2017 moderate CPT codes question with 2 different providers during one session

[Margaret Morgan]

Good morning,

I have a question regarding the new moderate (conscious) sedation codes; I am a cardiology coder and sedation has always been bundled with the catheterization and other procedure codes. I have been educating myself to be ready in January. However I have question about coding sedation when 2 procedures by two different physicians is performed during the same session.

an example is 65 year old patient has crushing chest pain and diagnostic catheterization is performed by doctor A. critical blockage is found but Doctor A is diagnostic cardiology and doesn't have the training to perform the intervention to place a coronary stent to open up the blockage. Doctor B, an interventional cardiology is called in and takes over the case. Doctor A leaves and Doctor B places a stent to open blockage. Too make this easier for me to understand, lets say each procedure took 15 minutes.

My question, how do I bill the sedation? Is it billed under Dr. A? Or is it split between the two providers? Do I bill 99152 and 99153 under Dr. A or do I bill 99152 twice? Once under Dr. A and again under Dr. B?

Thank you in advance for your help or suggestions on where to look for an answer.

Sincerely,

Margaret, CIRCC

 

[willnat2]

Hi Margaret,

Did you ever find out the answer to your question? I have one provider that does the heart cath and if the patient needs a stent they have to call in another provider from our practice and they take over. I have been denied also when I post two 99152's. The first provider leaves and the second one takes over the case. Just wondering if you have found out anything.

Thank you