# Pain management - Is it ever appropriate for a pain



## cyrucats (Aug 5, 2009)

Is it ever appropriate for a pain management physician who is doing a 64520 under fluroscopic guidance to have an anesthesiologist present and billing for a 01992-QS.  I normally do not see both physicians billing this treatment at the same time.  If this is appropriate, can you tell me of a situation that would warrant both physicians being medically necessary?  The treatment notes do not support this.

Thanks in advance for any and all help.


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## Thath041 (Sep 30, 2011)

Our pain Dr. Does MCS for these so he bills out the 99144 however. If the patient had to have MAC or Gen/Regional Anesthesia for another reason the Anesthesiologist can bill out for that.


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## dwaldman (Oct 3, 2011)

It would be medically necessary if it was determine  that this was the safest and most effective approach at sedating the patient for the given procedure.  If there is a concern, for procedure that might typically require no sedation or only conscious sedation, you can relay to the physician performing the procedure that documentation of the indication for level sedation for the procedure should be included in the medical record.


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## Peter Davidyock (Oct 4, 2011)

The physician would not bill for MAC, that's why it's not in his notes.
Don't bill it.
MAC codes can only be billed by anesthesiologists.


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