tci ED Coding & Reimbursement Alert - 2015 Issue 9

Reader Questions: Wake Up To Appendix G Language For Accurate Moderate Sedation Coding

Question: I have a question regarding the use of the 99148-99150 code. In our practice we see a lot of pediatric patients with fractures and perform conscious sedation to allow the Orthopedist to do the fracture reduction and cast the patient. Our coders are stating that they cannot give us credit for the sedation under the 99148-99150 “Moderate Sedation provided by a physician, other than the health care professional performing the diagnostic or therapeutic service that the sedation supports,...” because our Emergency Department is “classified” as an outpatient setting as determined by the types of codes...

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