tci Medicare Compliance & Reimbursement - 2008 Issue 23

Reader Question: Zoom In On 'Targets' Before Coding Moderate Sedation

Hint: You can't always bill moderate sedation separately Question: An established patient complaining of rectal pain and abdominal cramps reports to our surgeon. During a level-four E/M service, the surgeon discovers a foreign body (FB) in the colon. The surgeon then removes the FB via flexible sigmoidoscopy. Due to the patient's anxiety and pain, the surgeon provides 26 minutes of moderate sedation during the procedure. Can we report the sedation separately? Answer: You cannot report moderate sedation separately in this case. CPT bundles moderate sedation into all of the sigmoidoscopy codes, so your claim cannot include 99144 (Moderate sedation...

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