Wiki GI Endoscopy(45378, 45380, 43235, 43239 etc) and Anesthesia 2018 (00731, 00811, 00812

[kboyd22]

Is anyone else having trouble with payers bundling anesthesia and GI Endoscopies? I do not understand why they created new anesthesia codes to be more precise if they were just going to bundle them? Having similar problem with conscious sedation 99152, only a modifier is allowed and being used (59) but still denying as invalid modifier.

 

[CodingKing]

Many payers require auth for other than conscious sedation. 00731, 00811, 00812 should be billed separately by the anesthesiologist so it shouldn't be bundled.

As for conscious sedation. Some of the payers delayed implementation of the change where conscious sedation is not included in the GI code. I know of one that did not allow it prior to 9/2017.