tci ED Coding & Reimbursement Alert - 2007 Issue 3

When You See a 'Targeted' Code, Think Twice Before Reporting Moderate Sedation

Good news: Some insurers are now reimbursing sedation codes, experts say When your ED physician performs moderate (or conscious) sedation on a patient, there may be some reluctance to report the sedation code to the insurer. After all, many carriers are still not reimbursing for the service, which CPT anointed with a new code set in 2006.Leaving these codes off the claim could be a mistake, however, because some insurers have started paying for moderate sedation, says Robert LaFleur, MD, FACEP, of Medical Management Specialists in Grand Rapids, Mich.-Reimbursement for moderate sedation has been spotty,- he...

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