If you’re weary of submitting medical necessity letters to support providing anesthesia to a patient who couldn’t take sedation, don’t worry, there’s good news for you. ICD-9 2010 provides stage-specific codes for gout and gives individual codes for irritability and two buckle fractures.
Take this situation for instance: A gastroenterologist wants your anesthesiologist to provide anesthesia for a patient undergoing a colonoscopy because the patient has had a previously failed moderate sedation session. Here you’ve got to explain the circumstances so that the insurer will cover the anesthesia.
ICD-9 2010 certainly comes to your rescue as it provides specific code that describes this picture. The new code V15.80 (personal history of failed moderate sedation) will support the medical necessity for an anesthesiologist to provide anesthesia services in place of moderate sedation which didn’t work in the past.
Here you’ll do well to report the colonoscopy anesthesia diagnosis first, followed by the personal history code. The surgeon who carried out the original procedure in which the moderate sedation was not effective would use new code 995.24 (Failed moderate sedation during procedure). Going forward, this patient will have a history of failed moderate sedation.
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