tci ED Coding & Reimbursement Alert - 2011 Issue 8

Reader Question: Stay Alert to the Degree of Anesthesia Used with Orthopedic Procedures

Question: Would 23655 be the appropriate code for closed reduction of shoulder dislocation with conscious sedation?Oregon SubscriberAnswer: No, code 23655 (Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia) would not be appropriate for a case using moderate sedation. When CPT® uses the phrase, "with anesthesia", it means "with general anesthesia" for a service typically performed in an OR. To code orthopedic services in conjunction with conscious sedation use the appropriate orthopedic codes "without anesthesia," along with the conscious sedation code if supported by the documentation. In this case, use code 23650 (Closed treatment of shoulder dislocation...

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