Wiki Moderate sedation-code for outpatient

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vjefcoats

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Good morning!

I code for outpatient hospital and we have started doing pain treatment injections by CRNA. Can I bill for conscious sedation 99144 with 62311, 64493 etc.??? I ran this through 3M and it was not bundled.
Just need clarification/documentation.
Thanks for input!
Vicki, CPC
 
Yes, you can bill for moderate sedation with pain procedures. Some payers cover it and some don't. We have found that Medicaid, in more than one state, does not cover it, but other insurances like BCBS and Medicare do. Check with your payers to make sure of coverage and guidelines. Also, be sure to follow CPT's time guidelines (over halfway mark for each time-based code) So for 99144 your provider should have at least 16 minutes of monitoring documented, and must have qualified healthcare personnel in the room monitoring the patient during the procedure.
 
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