Payment for procedural sedation

Current Opinion in Anaesthesiology

Volumn 17, Issue 2, 2004, Pages 171-176

  Hannenberg, Alexander A ^a,b  

^a TUFTS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b NONE   (United States)

Author keywords

Monitored anesthesia care; Payment; Reimbursement; Sedation

Indexed keywords

SEDATIVE AGENT;

ANESTHESIST; CODING; CONSCIOUSNESS; ECONOMIC ASPECT; HEALTH CARE PERSONNEL; HEALTH CARE POLICY; HOSPITAL BILLING; HUMAN; MEDICAL SERVICE; MEDICAL SPECIALIST; MEDICARE; NURSE; NURSING STAFF; PRIORITY JOURNAL; REVIEW; SEDATION; TREATMENT PLANNING; WORK;

EID: 2342437493     PISSN: 09527907     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001503-200404000-00014     Document Type: Review

References (16)

1. ••] for the most recent version.
2. Title XVIII Social Security Act Section 1842 (42 USC 1395u).
3. National Heritage Insurance Company. Local medical review policies [online] 2003. http://www.medicarenhic.com/lmrp/final/ne/nelmrpindx.htm. [Accessed 27 July 2003]
4. Empire Medicare Services. LMRP for anesthesia with gastrointestinal endoscopy #L3033 [online] 2002. http://www.cms.hhs.gov/mcd/viewlmrp.asp?lmrp_id= 3033&lmrp_version=4&show=all. [Accessed 15 July 2003] A typical medical necessity policy for MAC except for the unique provision regarding propofol administration.
5. Vargo JJ, Zuccaro G, Dumot JA, et al. Gastroenterologist-administered propofol versus meperidine and midazolam for advanced upper endoscopy: a prospective randomized trial. Gastroenterology 2002; 123:8-16.
6. Rex DK, Overly C, Kinser K, et al. Safety of propofol administered by registered nurses with gastroenterologist supervision in 2000 endoscopic cases. Am J Gastroenterol 2002; 97:1159-1163. A large case series of nurse-administered propofol that challenges views widely held by nurses and anesthesiologists about each other's role in propofol sedation.
7. Walker JA, Schleinitz PF, Jacobson KN, et al. Propofol: multiple advantages for endoscopy and colonoscopy in 1,424 consecutive patients [Abstract]. Gastrointest Endosc 2000; 51:AB59.
8. American Society for Gastrointestinal Endoscopy. Guidelines for the use of deep sedation and anesthesia for GI endoscopy. Gastrointestinal Endoscopy 2002; 56:613-617. An important document not only because of its official status, but also for the concise review of the literature contained in the guidelines.
9. National Center for Health Workforce Analysis. Projected supply, demand and shortages of registered nurses 2000-2020 [online]. http://bhpr.hrsa.gov/ healthworkforce/mproject/. [Accessed 23 November 2003]
10. Epstein BS. The American Society of Anesthesiologists' efforts in developing guidelines for sedation and analgesia for nonanesthesiologists: the 40th Rovenstine Lecture. Anesthesiology 2003; 98:1261-1268. An authoritative overview of the evolution of sedation guidelines from a participant in most of the process. This review concentrates on safety and credentialing issues more than payment rules.
11. Eckhout G, Schubert A. Where have all the anesthesiologists gone? Analysis of the national anesthesia worker shortage. ASA Newsletter 2001; 65:16-19.
12. Centers for Medicare & Medicaid Services. Federal Register 2001; 66:55292.
13. Centers for Medicare & Medicaid Services. Federal Register 2001; 66:31060.
14. Noridian Administrative Services, LLC, Medicare Part B. LMRP monitored anesthesia care [online] 2003. http://www.noridianmedicare.com/provider/pubs/ med_b/policy/final/11state/B2003_19.pdf. [Accessed 16 November 2003] A new MAC medical necessity policy noteworthy for the recommendation to reduce gastrointestinal fees when anesthesiologists provide sedation.
15. American Society of Anesthesiologists. Definition of general anesthesia and levels of sedation/analgesia [online] 1999. http://www.asahq.org/ publicationsAndServices/standards/20.htm. [Accessed 25 July 2003]
16. American Society of Anesthesiologists. Position on monitored anesthesia care [online] 2003. http://www.asahq.org/publicationsAndServices/standards/23. pdf. [Accessed 16 November 2003] The most current official ASA statement on MAC, redefining the scope of the service and the distinction between MAC and general anesthesia.