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Wiki Reporting Sedation

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avon4117

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Our physician performs kyphoplasty's in an office setting. I normally bill the procedure code. But we have a new practice manager that says I should be billing for the moderate sedation code and the flouro even though its inclusive in the procedure. She states it for reporting purposes. I have never heard this before. I am not the type of person to immediately dismiss a suggestion because in the world of coding, you are learning something new everyday. But I would like to reach out to my fellows coders and see what you guys think...:confused:
 
Under NCCI guidelines, the imaging and the sedation (if performed by the same provider) should not be reported - this would be unbundling. The charges would deny and you would not be able to support billing a modifier, based on what you've said. If the practice needs the codes in their system for some kind of internal 'reporting' purposes, you could put them in with a zero charge or set them up so they don't go out on the claim form which would allow for tracking if that's what is needed.
 
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