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Wiki ED visit with mod sedation/anesthesia

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apollo06

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Suffolk, VA
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Hi
Here is my scenario:
child comes into ED for laceration on vulva from a fall. ED physician administers ketamine IV (moderate sedation) and surgeon comes in and sutures lac.
So I have two different providers performing services. Our coding company is billing the ED visit with anestheia codes because it is two different providers.
I thought I read somewhere that it IS appropriate to bill anes codes when thier are two different providers performing the service EVEN though its really moderate sedation being performed.
Medicaid is denying the ED visit and paying the anes code.
Can someone point me in the right direction of how to bill appropriately, any references?

thanks in advance!
 
More information is really needed to help answer your question. You did not share the codes you had in question and what modifier's were used. I have provided an example of how I would think it would possibly be billed if I found separate E&M documentation from the procedure note/paragraph for the MCS.

Scenario:
9928x-25
99148 (xxx global indicator) age 5 or less
 
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