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ED Coding and Reimbursement Alert

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KO Sedation Questions by Checking for CPT Signs

Published on Thu Jan 20, 2011

Question: A 44-year-old patient reports to the ED with an injured left shoulder; a level-four E/M service reveals that the patient has a shoulder dislocation; due to the patient's constant complaints of pain and raised anxiety during the E/M service, the ED physician provides 22 minutes of Fentanyl sedation, during which time he performs closed treatment with manipulation of the dislocated shoulder. There is an independent, licensed observer present to monitor patient status during the procedure.. Can I report the sedation separately in this scenario?Answer: This procedure is not on the list of codes that cannot be reported in conjunction with moderate sedation services, so you should be safe coding the sedation separately. On the claim, report the following:23650 (Closed treatment of shoulder dislocation, with manipulation; without anesthesia) for the shoulder repair99149 (Moderate sedation services [other than those services described by codes 00100-01999], provided by a physician other than the [...]
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