ALALA
Networker
I have a case where our anesthesiologist provided the MAC sedation for a 14 yo patient w/ severe autism (violent outbursts), chiari malformation and autoimmune deficiency, while the IV Infusion of Gammagard was done. My MD stayed with the patient, monitoring, charting, etc for the full 4 + hours of infusion as prescribed by the patients PCP. The service was provided in the PACU of the hospital. I want to use the 96365 but there isn't a crosswalk. Would using 01999 be appropriate in this case, while sending all documentation available? I think the unusual circumstance of this case would meet the medical necessity, but am looking for confirmation from others. Has anyone else dealt with this?