tci ED Coding & Reimbursement Alert - 2004 Issue 12

Reader Questions: Verify Rules Before Using-47 and Anesthesia Codes

Question: Because conscious sedation codes only apply when a patient is still verbally responsive, what if a provider gives deep sedation so he can perform a procedure, such as a shoulder reduction? Can we bill the shoulder reduction with modifier -47 and still report an anesthesia code for the deep sedation?Michigan Subscriber Answer: According to the American Medical Association publication Coding With Modifiers, you should append modifier -47 (Anesthesia by surgeon) when the surgeon provides her own regional or general anesthesia. In such a case, you would apply modifier -47 to the surgical code and not report anesthesia...

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