Otolaryngology Coding Alert

In years past, Medicare considered conscious sedation procedures 99141-99142 bundled services in all cases, and therefore would not pay separately for them. Although 99143-99150 are much more precise than 99141-99142, Medicare's recently released 2006 fee schedule assigns zero relative value units to the new codes--and that means Medicare still won't pay.

Most experts aren't surprised by Medicare's decision. -I have dealt with Medicare, and they say that uncomfortable procedures that require sedation have CS built into the surgical global fee,- says Scott Groudine, MD, an Albany, N.Y., anesthesiologist.

Groudine does see some hope for the future, however: -I would not be surprised if there were an attempt to provide payment for physicians who are solely giving sedation to children under 5 years old (99148) because CS in these cases actually means more work than when performed on an adult. If there is to be any payment for CS codes [by Medicare], I think it would start in the pediatric sedation codes.-