Gastroenterology Coding Alert

Question: The gastroenterologist meets an 83-year-old established hospice patient at the hospital. A hospice caretaker says the patient has not defecated in four days, and the patient reports he has had pain nonstop for the past 12 hours. The gastroenterologist takes a detailed history and during a detailed exam, she diagnoses fecal impaction. The physician performs sedation with Versed and disimpaction; there was a qualified observer overseeing the sedation. The physician then counsels the caretaker on caring for the patient and recommends a follow-up visit with the patient's primary care physician within two weeks. I reported 45915 for the disimpaction and got a denial. What happened? Alaska Subscriber Answer: You should have coded the disimpaction differently. When you re-submit the claim, report the following: • 99143 (Moderate sedation services [other than those services described by codes 00100-01999] provided by the same physician performing the diagnostic or therapeutic service that the [...]