Trish Posted Fri 21st of December, 2012 17:06:25 PM
can cons. sedation code 99143 be used with GI procedures egd and or colonoscopy? will medicare or commercial insurance pay?
SuperCoder Answered Thu 03rd of January, 2013 20:16:11 PM
The answer is no.
CPT indicates conscious sedation is bundled into many procedures. This means the physician performing both these procedures and conscious sedation could not code separately for conscious sedation. This policy has been extended into CPT for Moderate (Conscious) Sedation. Appendix G of CPT 2012 lists 321 procedure codes which include MCS. Codes bundling MCS are denoted with a target symbol in the CPT book. CPT further instructs, in the circumstances when the patient does not require sedation, the operating physician is not required to report the procedure as a reduced service using modifier 52.
Codes of interest to emergency medicine bundling Moderate (Conscious) Sedation include the following:
31615 tracheobronchoscopy through tracheostomy
31622 bronchoscopy diagnostic
32551 chest tube insertion
33210 insertion transvenous pacemaker
36555 insertion pediatric (under age 5) central line
36568 insertion pediatric (under age 5) PICC line
92953 transcutaneous pacing
92960 elective cardioversion
Do not report codes 99143-99145 with procedures listed in Appendix G.