# Can ED MD bill anasthesia codes in ED when performing using propofol?



## kviolet (Sep 12, 2011)

Can ED MD bill anasthesia codes in ED when performing that procedure using propofol?

- oncology patient requiring bone marrow biopsy
- PICC line placement
- lumbar puncture
- neuro patient for MRI sedation

We have been billing for moderate sedation in ED not anasthesia codes 
Thanks


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## FTessaBartels (Sep 13, 2011)

*Conscious Sedation*

I would also use Conscious Sedation (Moderate Sedation) codes, not Anesthesia codes.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## sam_son  (Sep 13, 2011)

My self also use only moderate sedation codes for ED physicians, Anesthesia codes will not be given for ED physicians.

Thanks


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## Peter Davidyock (Sep 14, 2011)

The anesthesia codes you want to use fall under the classification of MAC (Monitored Anesthesia Care) and therefore require an anesthesiologist or a crna. They would bill those codes, not the ED MD. The best the MD can do is concious sedation but you will have to document the presence of someone else in the room attending to the pts vitals.


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## kviolet (Sep 14, 2011)

Have you heard about some changes from CMS in January 2011 that EDP can perform deep sedation in ED ??

Here is an article by Dr. Kevin Klauer on the CMS policy:  http://www.epmonthly.com/features/c...d-deep-sedation-a-win-for-emergency-medicine/


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## Mojo (Sep 14, 2011)

Yes, Ed posted this on the Supercoder listserv. Between the turf war with anesthesia (look at the politics involved with trying to bill 93010 by the EDP) and the risk management and staffing issues for the facility, I'd be surprised to see it implemented. I would not consent to it in a chaotic ED.


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## alisonbee (Nov 1, 2011)

kviolet said:


> Can ED MD bill anasthesia codes in ED when performing that procedure using propofol?
> 
> - oncology patient requiring bone marrow biopsy
> - PICC line placement
> ...



We would charge Moderate Sedation when appropriate, and the procedure performed is not listed in Appendix G.


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