Cardiology Coding Alert

Question: Is conscious sedation billable if trans-esophageal echocardiography (TEE) is performed in the office setting? I know it's bundled in the hospital setting. New Jersey Subscriber Answer: You can bill conscious sedation (99141, Sedation with or without analgesia [conscious sedation]; intravenous, intramuscular or inhalation) when performed for a TEE procedure in the office. For the in-office TEE, report 93312 (Echocardiography, transesophageal, real time with image documentation [2D] [with or without M-mode recording]; including probe placement, image acquisition, interpretation and report). Practices need to have recovery areas available for conscious-sedation patients and personnel available for patient monitoring.

The requirements for conscious sedation must be met. Specifically, someone besides the physician performing the service must be monitoring the patient's vital signs. This person must be an employee of the physician, such as a registered nurse. Consult with your insurance carrier about conscious-sedation guidelines. Often carriers bundle conscious sedation into procedures. Answers to Test Yourself and Reader Questions were provided by Janet White, RN, CPC, CMM, practice manager for a cardiovascular outpatient facility in Seneca, S.C., and president of the South Carolina Medical Office Managers group; Martha Gerant, CPC, professional coder and reimbursement specialist for Cardiology Services in Olathe, Kan.; Deborah Ovall, CMA, CCS, CIC, a coding and reimbursement specialist with Medical College Hospitals of Ohio at Toledo; Becky Heintzman, CPC, a coding specialist with Cardiology Specialists of NC in Winston-Salem, N.C; and Sandy Fuller, CPC, a cardiology coding and reimbursement specialist in Abilene, Texas.