tci General Surgery Coding Alert - 2003 Issue 3

Reader Question: Conscious Sedation

Question: I have read that conscious sedation by a physician performing an endoscopy is not covered, but I've also been told that I can have patients sign a waiver making them responsible for payment. Which is correct? Can we receive payment for conscious sedation with endoscopy? Oregon Subscriber Answer: Medicare and most private payers do not reimburse for conscious sedation (99141, Sedation with or without analgesia [conscious sedation]; intravenous, intramuscular or inhalation; and 99142, ... oral, rectal and/or intranasal), regardless of circumstances, and bundle the service to all surgical/diagnostic procedures. Because the service is bundled, or included (as opposed to...

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