Anesthesia Coding Alert

Question: I know we can charge for conscious sedation (99141) in addition to gastrointestinal procedures. Can we charge for it in addition to any other services? If so, under what circumstances? Must the trained observer needed for conscious sedation be a physician, or can we use a nurse?

Massachusetts Subscriber
 
 Answer: Conscious sedation is typically provided by the operating surgeon during an uncomfortable procedure; coding appropriately for it depends partly on who provides the service. Conscious sedation codes 99141 and 99142 (... oral, rectal and/or intranasal) are intended for the surgeon rather than the anesthesiologist. For example, if an anesthesiologist provides sedation during a colonoscopy, it is considered MAC anesthesia and is coded with modifier -QS (monitored anesthesia care service). If the endoscopist administers sedation with the help of a nurse, it would be considered conscious sedation. The trained observer you mention can be a nurse.