Anesthesia Services and Your Insurance Coverage

You are scheduled for an endoscopic procedure (colonoscopy or EGD) at Pend Oreille Surgery Center.

You doctor has requested anesthesia services to provide Propofol anesthesia for this procedure.

The Propofol anesthesia services were requested by the physician performing the procedure for several reasons, some of which include:

  • Patient movement, coughing and discomfort are substantially reduced
  • Use of Propofol allows more efficient use of procedure time (less time spent waiting for medication to take effect), better visualization of structures as well as a greater confidence in thoroughness of examination
  • Recovery is more rapid than with nurse administered sedation, allowing the patient to be discharged with a greater confidence of safety and decreased possibility of side effects
  • Patient satisfaction is improved

FDA guidelines indicate that, to ensure patient safety, only an anesthesia provider should administer Propofol. The American Society of Anesthesiologists and The America Association of Nurse Anesthetists stand behind the FDA in these guidelines and reinforce the importance of having a trained anesthesia provider in attendance for these procedures.

Your insurance company may or may not cover the cost of the anesthesia services. In the event of a denial of the anesthesia billing you will be responsible for the cost of services. On the day of the procedure you will be asked to sign an advanced billing notice (ABN) indicating your understanding of the possibility of billing, and your responsibility, for anesthesia services. If you have questions or concerns about this policy, you should discuss them with the anesthesia provider prior to the day of your procedure or request other arrangements.

Your specific policy may have more information regarding covered services. Before you arrive for your procedure, you may wish to consider calling your insurance company for clarification. The Anesthesia procedure codes in question are 00810 (colonoscopy) and 00740 (EGD).