tci ED Coding & Reimbursement Alert - 2002 Issue 2

Wake Up to Differences between Conscious Sedation and Anesthesia Codes

Emergency department coders often say they are in a quandary about how to correctly report procedures that involve conscious sedation and anesthesia. CPT includes codes and definitions exclusively for conscious sedation, as well as procedure codes that allow for anesthesia during specific services. However, contradictory definitions of what constitutes anesthesia abound, causing confusion about when to report conscious sedation services as opposed to codes that refer to "with anesthesia." Reimbursement policies also vary wildly from payer to payer, adding to the bafflement of professional coders. Understanding Conscious Sedation Most clinicians and coders agree on what constitutes conscious sedation...

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