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Noridian: Report costs of recovery under revenue code 710

APCs Weekly Monitor, November 3, 2006

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Noridian: Report costs of recovery under revenue code 710

Nordian Administrative Services LLC, fiscal intermediary (FI) for the states of Alaska, Idaho, Minnesota, North Dakota, Oregon, Utah, and Washington, recently hosted an open door forum in which a provider asked the question below. In its answer, Noridian stated to report charges for recovery room costs under revenue code 710.

Note that the following guidance was issued from a specific FI; please consult with your own FI before altering billing practices in your hospital.

QUESTION: CPT code 93501 includes conscious sedation as an inherent part of providing the procedure. Conscious sedation includes recovery as part of this charge. Can we charge recovery room services for this?

ANSWER: Reimbursement for any procedure includes "return to baseline" (CCI Coding Manual) from the intervention and includes elements such as consciousness, hemostatis, and airway protection. Since right heart catheterization (CPT 93501) requires sedation and alteration of consciousness, recovery is required and the APC includes payment for the same. Charges for the costs of recovery should be reported under revenue code 0710. Note: conscious sedation is not paid separately.

You can find the Q&A at the Noridian Web site: https://www.noridianmedicare.com/cgi-bin/coranto/viewnews.cgi?id=EEuAVFuVpkfCubaqLJ&tmpl=part_a_viewnews&style=part_ab_viewnews.

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