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Guest
#1 Posted : Tuesday, August 22, 2017 11:04:07 AM(UTC)
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Guest

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I very rarely have to bill medical for wisdom teeth. Well we have changed things and we now offer IV conscious sedation (bill out D9248, D9910, and D9610). Does this get grouped into one code for billing like 99145? How do I find the N4 code?

We used:
Dex 8mg
Fent 50mg and 25mg
Versed 5mg, 2.5mg, and 2.5mg
Propofol 10 mg

Can you help me figure this out so I can get a medical claim out in the mail?

courtneydsnow
#2 Posted : Tuesday, August 22, 2017 1:17:13 PM(UTC)
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courtneydsnow

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Hi Guest!

Below are the new moderate sedation coding options:

99151
Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient younger than 5 years of age

99152
Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older

99153
Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; each additional 15 minutes intraservice time (list separately in addition to code for primary service)

99155
Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger than 5 years of age

99156
Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient age 5 years or older

99157
Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; each additional 15 minutes intraservice time (list separately in addition to code for primary service)


As for the n4 code - usually the National Drug Code will be found on the packaging or insert for the drug. Here is a link to the NDC directory: https://www.fda.gov/drugs/informationondrugs/ucm142438.htm

Hope this helps!
Guest
#3 Posted : Wednesday, August 23, 2017 9:56:46 AM(UTC)
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Thank you so much for that. So if 3 or 4 drugs are used, do I group it on one line item and have multiple codes N4 codes?

Ex

N40641606010 N40641602725 N46332316530
99152
Guest
#4 Posted : Wednesday, August 23, 2017 9:58:21 AM(UTC)
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Also, I am not sure I even got the right codes. I used NDC code, is that right?

Bridget
courtneydsnow
#5 Posted : Thursday, August 24, 2017 9:33:13 AM(UTC)
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Hi Bridget!

Yes if you are going to include the NDC codes on the claim form, I would enter them onto the red shaded line on the line item where you enter the sedation code (right above where the date of service and code goes).

Guest
#6 Posted : Thursday, August 24, 2017 12:03:35 PM(UTC)
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I'm sorry. I am very confused. I don't know what to do and without an example I do not understand what you are saying. I got the sedation meds and did not see N4 code, all I saw was the NDC code.
courtneydsnow
#7 Posted : Thursday, August 24, 2017 12:16:29 PM(UTC)
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courtneydsnow

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Hi Bridget!

From my understanding, N4 is a qualifier that indicates that the code is an NDC code on the claim form.

Here is a link to a guide provided by BCBS of TX that explains further and has an example available (on page 4): https://www.bcbstx.com/provider/pdf/ndc_faqs.pdf
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