Results 1 to 6 of 6

Moderate Sedation

  1. Default Moderate Sedation
    Medical Coding Books
    I am unable to find clear written guidance regarding moderate sedation. My question is when coding moderate sedation do you pick up the HCPCS J codes for the medications used to induce the sedation?

    Thank you

  2. #2
    Location
    Greater Orlando
    Posts
    146
    Default Billing moderate sedation?
    Does the procedure in question include moderate sedation? Was it administered by the physician performing the procedure? If so, isn't the cost of the anesthetic agent also included and therefore not billable, like other supplies incidental to a procedure?

    CPT 2012 Appendix G in its directions provides that moderate sedation is billable when administered by a different physician from the health care professional performing the procedure.
    Ron McKenzie, CPC-A
    Greater Orlando FL Chapter

  3. Default Moderate Sedation
    Yes the code does include moderate sedation and the provider performing the procedure is the one that is providing the sedation.

    The problem I am having is I agree that the anesthic agent would be included but some of my providers disagree. I was looking for soemthing in writing that would state either way.

    Thank you,

  4. #4
    Default
    If this is in a setting where you are responsible for billing for the drug I believe that you could bill the drug separately from 99144/99145 for example.

  5. #5
    Location
    Greater Orlando
    Posts
    146
    Default What anesthesiologist?
    dwaldman,

    As I understand the facts, there is no anesthesiologist. The physician performing the procedure is administering the moderate sedation for a procedure identified in App G as Includes Moderate Sedation. Since there is no anesthesiologist**, CPTs 99144/99145 are N/A as I understand it. (** or separate physician administering the moderate sedation)

    So, since administration of the moderate sedation is included in the procedure, does it follow that the cost of the agent used for the moderate sedation is also covered by the billing for the procedure and is not separately billable?
    Ron McKenzie, CPC-A
    Greater Orlando FL Chapter

  6. #6
    Default
    Now I see what the scenario is but I don't believe the CPT manual or CPT Assistant states not to bill for a drug, They might state the procedure is considered inclusive but I am leaning towards that does not prevent the reporting of the drug itself. Sorry I didn't originally read the following responses and additional questions close enough.

Similar Threads

  1. Moderate Sedation
    By sp485 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 03-13-2017, 10:08 AM
  2. Moderate sedation-code for outpatient
    By vjefcoats in forum Anesthesia
    Replies: 1
    Last Post: 06-30-2014, 11:18 AM
  3. moderate sedation
    By jalderson in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 07-18-2013, 12:06 PM
  4. Moderate sedation
    By shyjuyohannan in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 05-23-2013, 06:29 AM
  5. Moderate Sedation-My doc sometimes
    By dmrussell in forum Anesthesia
    Replies: 5
    Last Post: 01-06-2011, 10:54 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.