Neurology & Pain Management Coding Alert

Question: Can the physician who performs a discogram also provide anesthesia during the procedure?

Colorado Subscriber

Answer:  The correct answer depends on the type of anesthesia administered.

The physician can bill for both the sedation and the discogram if he uses moderate sedation as described by 99144 (Moderate sedation services [other than those services described by codes 00100-01999] provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; age 5 years or older, first 30 minutes intra-service time). If the physician requested monitored anesthesia care, however, another separate physician or qualified healthcare provider (such as a CRNA) needs to administer the anesthesia. In that case, your physician should only bill for the discogram while the other anesthesiologist or CRNA would bill for the anesthesia services.

Remember: Moderate sedation services are time-based and require exceeding the midpoint of the code descriptor time frame before it is billable. For example, before you can report 99144, the moderate service intraservice time would need to be at least 16 minutes in order to bill the code.