Wiki 01936 with no anesthesia drugs

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betsycpcp

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We have a pain management practice that is billing 01936 for a CRNA when the anesthesia record shows no anesthesia drug was given. The space where they would normally show when they administered Propofol, Versed, etc is left blank. They indicate that blood pressure, EKG, and oxygen were monitored for a certain amount of time, and that seems to be all the CRNA did. Doesn't 01936 require that some type of anesthetic agent be given?
 
Yes! 01936 does require the use of anesthetic medications to be billable. Who is performing the sedation? Or, is there any sedation being given? If there is no anesthesia given, the CRNA cannot code for 01936 or any additional services. My question is why would a CRNA be present if there is no need for monitoring and no drugs are given?

Can you send me an example of what you are talking about so I can make a better decision on how to help you?

Thanks and hope this helps!
 
Hi Amy,
Thanks for your reply- I forgot to look for replies until today. We are the payer and we have been getting bills from a pain management practice where they send a separate bill for a CRNA when someone is getting a transforaminal epidural injection or something similar. In a phone call they confirmed that the reason they don't mark any drugs on the anesthesia record is that none are given for sedation. And the physician's procedure note doesn't list any sedation drugs --just local anesthetic and the contrast and steroid. They believe they should be paid for the CRNA just monitoring BP, EKG, etc. We've told them that's not moderate conscious sedation so they can't bill 99144, but they disagree. We don't see any other providers billing that way so I just wondered if anyone has heard of anything like this.
 
In the coders desk reference it states that the provider administers medication to lower a patient level of consciousness. When administering a local and steroid, the patient level of consciousness has not been lowered. So there is no conscious sedation status being monitored.
 
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