# Deep Sedation and Conscious Sedation TEE/Cardioversion etc



## lawrencema1490 (Feb 13, 2018)

Hello,

I work for a Cardiology group and we bill from an outpatient physician setting. One of our providers wants us to bill for conscious sedation for TEE's and Cardioversions done and he states that deep sedation is done. I would not just be able to code down to conscious sedation code 99152 correct? Either they do deep sedation or conscious sedation. As far as deep sedation goes isn't that something that the anesthesiologist bills? Any help with this would be greatly appreciated!

Thank You!


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## theresa.dix@tennova.com (Mar 1, 2018)

lawrencema1490 said:


> Hello,
> 
> I work for a Cardiology group and we bill from an outpatient physician setting. One of our providers wants us to bill for conscious sedation for TEE's and Cardioversions done and he states that deep sedation is done. I would not just be able to code down to conscious sedation code 99152 correct? Either they do deep sedation or conscious sedation. As far as deep sedation goes isn't that something that the anesthesiologist bills? Any help with this would be greatly appreciated!
> 
> ...



You are right. If an anesthesiologist is there administering the deep sedation he will be billing for his services and if you bill also for the physician which is what 99152 is you would be double dipping. 99152 is for the physician who is supervising the administration of the conscious sedation. Usually by a nurse (RN).


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## twizzle (Mar 1, 2018)

*Deep sedation and conscious sedation*



lawrencema1490 said:


> Hello,
> 
> I work for a Cardiology group and we bill from an outpatient physician setting. One of our providers wants us to bill for conscious sedation for TEE's and Cardioversions done and he states that deep sedation is done. I would not just be able to code down to conscious sedation code 99152 correct? Either they do deep sedation or conscious sedation. As far as deep sedation goes isn't that something that the anesthesiologist bills? Any help with this would be greatly appreciated!
> 
> Thank You!



Moderate conscious sedation and deep sedation are not the same thing. Theoretically only an anesthesiologist or CRNA can bill for deep sedation but there are exceptions.
I encountered this problem a few weeks ago when auditing pediatric critical care; on two occasions the provider was administering deep sedation which I questioned. Apparently he is licensed to perform deep sedation, aka anesthesia so the anesthesia codes rather then moderate sedation codes would be correct
For TEE's and cardioversions I think moderate sedation is usually performed which your provider may well bill for depending on who is administering it. As the previous poster said, it is most likely an RN. There is no way a cardiologist would be able to bill an anesthesia code but if an anesthesiologist administers deep sedation for the procedures then your provider would not bill anything other than the TEE and cardioversion.
Hope that makes sense.


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