# Fracture care w/ IV sedation



## Maureen Kielian (May 22, 2013)

Patient has closed fracture of radius and ulna. EM level of 99284
 ED physician performed IV sedation, and post reduction X-ray is satisfactory. ED does not indicate that a reduction was performed. Casting was done separately by ortho tech.
 In addition to the EM, what other CPT codes would be added?


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## SAllard607 (May 23, 2013)

If the physician documented the intra-service time for the procedural sedation you could bill for that from the code set 99143-99150. These are based on time spent, age of patient, and involvment of outside physician for procedure.


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## mitchellde (May 23, 2013)

I would have to query the provider as to whether he has a procedure note to add, this is the ED so the provider cannot bill the IV sedation that will be billed by the facility.  So no procedure note then it is only an E&M.


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## ashack63 (May 23, 2013)

*Cons Sedation*



mitchellde said:


> I would have to query the provider as to whether he has a procedure note to add, this is the ED so the provider cannot bill the IV sedation that will be billed by the facility.  So no procedure note then it is only an E&M.



I would have to disagree with you, the ED provider can bill for the Conscious Sedation as he is the one responsible for it. The facility should also bill it, with an -N- staus indicator. They (facility) will not receive additional reimbursement, but it is tracked by CMS.

Not all carriers will pay additionally for the Conscious Sedation codes, but if you do not bill them, there is a loss of revenue for those Insurance Companies that will pay. See article below:

http://www.supercoder.com/coding-ne...before-billing-for-conscious-sedation-article


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## mitchellde (May 23, 2013)

IV sedation and MAC are 2 different things, IV sedation can be an IV line with happy drugs to calm the patient , it truely depends on what is documented.  From only what is provied in the post it looks like a visit level only.


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