tci ED Coding & Reimbursement Alert - 2005 Issue 7

Reader Questions: Report Conscious Sedation Over Anesthesia

Question: The physician's notes state "reduction of shoulder dislocation, IV sedation, traction/countertraction." Should I report this with procedure code 23650, or 23655? New Jersey Subscriber Answer: In the emergency department, 23650 (Closed treatment of shoulder dislocation, with manipulation; without anesthesia) is generally more appropriate than 23655 (... requiring anesthesia).While there is no specific reference in CPT about the exact definition of anesthesia, American Medical Association personnel have stated that "with anesthesia" is intended to mean "with general anesthesia," not local. The added relative value units associated with the "with anesthesia" codes are not to reimburse the...

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