Pediatric Coding Alert

Question: A child comes in with a high fever, and the pediatrician suspects meningitis. The physician performs a spinal tap under moderate sedation. Should I report the sedation with 99143-99145 or 99148-99150?

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Answer: You can easily determine the correct code set if you answer this question: Does the sedation and procedure involve one physician or two?
 
• One MD: When a pediatrician performs the  procedure and provides the sedation, you should use  99143-99145 (Moderate sedation services ... provided by the same physician performing the diagnostic or therapeutic service that the sedation supports ...).
 
• Two MDs: When different physicians provide the procedure and service, use the second set of codes, 99148-99150 (Moderate sedation services ... provided by a physician other than the healthcare professional performing the diagnostic or therapeutic service that the sedation supports ...). In your case, one pediatrician performs the spinal tap (62270, Spinal puncture, lumbar, diagnostic) and provides the moderate sedation. So, you should choose the age-appropriate code from 99143-99144.
 
Don't miss: Codes 99143-99144 capture the first 30 minutes of intra-service time. For each additional 15 minutes, assign 99145.