The intent of conscious sedation is for the patient to remain conscious and able to communicate during the entire procedure. The patient retains the ability to independently and continuously maintain a patent airway and respond appropriately to physical stimulation and/or verbal command. Conscious sedation includes performance and documentation of pre- and post
sedation evaluations of the patient, administration of the sedation and/or analgesic agents, and monitoring of cardiorespiratory functions (pulse oximetry, cardio respiratory monitor, and blood pressure).
Conscious sedation may be administered by physicians (MDs) who have received training in moderate sedation. Follow 2006 CPT guidelines for the use of conscious sedation codes. Conscious sedation codes cannot be billed when anesthesia services are provided at the same time.
Deep sedation is a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Deep sedation may be administered by emergency medicine physicians (MDs) whose advance
practice training has prepared them for airway management, advanced life support and rescue from any level of sedation.
Use the appropriate anesthesia or surgical procedure code to bill deep sedation and indicate the exact number of minutes in direct recipient contact. When deep sedation is performed by emergency medicine physicians, add modifier AA to the procedure code.