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Anesthesia code

  1. Default Anesthesia code
    Medical Coding Books
    A patient was brought in ER and had bilateral proximal humerus fractures. The ER P.A. placed the patient in arm immobilizers. Anesthesia was brought in for this and utilized a total of 90 mg of propofol. Were able to obtain light sedation. Would there be an anesthesia code to use for this?

  2. Default
    just seeing if there is even an anesthesia code that we can use for this? any suggestions please.

  3. #3
    Is this homework or do you have additional information? If the sedation is not minimal, deep or requiring monitored anesthesia care, look at the Moderate (Conscious) Sedation code 9914x. When coding in the ED setting, there is usually a moderate sedation flowsheet in the medical record when moderate sedation is given.

  4. #4
    Yes there is but the anesthesiologist will be billing it not the ER Doc.

  5. #5
    Quote Originally Posted by Oceanlivin View Post
    Yes there is but the anesthesiologist will be billing it not the ER Doc.
    I agree, the moderate sedation would not be reported by the EDP in this scenario. I should have been more clear. My statement was meant to emphasize looking for the flowsheet when procedures are performed with sedation to gather more information.

  6. Default
    no this is not homework and thats why I didnt think I could use the moderate sedation codes as this is performed by the CRNA. Why I'm having difficulty is because the procedure was really only the ER doc putting on the arm immobilizers and I dont think there is a procedure code for that would there be. I think that would be included in the E & M. So am I still able to apply an anesthesia code for this. I'm open to suggestions. Thank you for those who have responded

  7. Default
    Sorry but I really dont have any more information than that like I had said the CRNA came in and administered sedation for the ER doc. I'm not sure what more that I could add that would be helpful. I'm just trying to find a code to capture this for the CRNA.

  8. #8
    So, there is no Moderate Sedation flowsheet? Is there documentation to support 99149 - drug, time, O2 sats, HR, BP, RR, patent airway, level of sedation? CRNAs do administer moderate sedation (depending on state scope of practice and facility policy).

    If the EDP isn't billing for fracture care, documentation may support shoulder strapping, 29240.

  9. Default
    ok just because I am not very good at coding anesthesia. Could I use 01620 for this. The CRNA did do a moderate conscious sedation record but I always thought that the 99149 sedation codes were only for when physicians administer sedation and if it was a Anesthesiologist or CRNA we had to use Anesthesia codes? If you would be able to explain I would appreciate it. I am confused some. Thank you

  10. #10
    99148-99150 codes are used when the provider administered the moderate sedation but did not perform the procedure (fracture care, endo). Hopefully, someone who specializes in anesthesia has a definite response with resources on whether moderate sedation billing is indicated.

    Since Propofol has the propensity for deeper levels of sedation you might be able to code for MAC if you have the documentation.

    In order to bill 01620, the definition for anesthesia services must be met. What about 01730?

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