But I'll just say, you know, this is very dependent upon your state and your institution. Keep up annually with what the regulatory and institutional trends are and what the requirements are. My suggestion would be, including for all the fellows out there that are moving forward and going to be practicing, maintain your institutional privileging steps for moderate sedation. Some places, that may include DEEP, depending on sort of where you are and what you're doing. And maintain current ACLS, BLS status. So I think that is important to emphasize that, you know, you have both of those skills, you're practicing them regularly, that you're familiar with airway rescue, particularly from deeper sedation spectrums. Next is to document possible DEEP sedation with patient written consent, you know, when performing these gastroenterologist-directed endoscopic sedation procedures, because it can happen with targeted moderate sedation, and you need to just make the patient aware that you're trained and you have the ability to, you know, kind of provide assistance should that occur. Use an electronic process, if possible, if at all possible, for assessment, and include something like that, that little HIPAA stop gap there, you know, you're going to have your time out that you have to do for your institution or your practice site or whatever it is, but get in your mind your own set of questions that you're going to go through every time before you start that sedation procedure, because you'll be surprised at how much you'll catch and how much your process will improve and the safety of those procedures will improve if you start doing it. And then I'll throw out there to kind of end with, and I'm going to try and shut up for a while and hear from you guys, sedation codes. So how do you bill for sedation if you're not administering anesthesiology-directed sedation? There's a G-code that is for sedation involving endoscopy, it is not billable for increments beyond 15 minutes, it's a one-time thing, and although, you know, there may be facility type aspects, this is more on the professional side for gastroenterologists, there's also a 99152 code that you'll see if you're using some of the automated coding systems. But you know, I think depending on your state and your payers, that may or may not be something that they actually pay for. It appears that that G-code is pretty universally covered, although it's a lesser code, a lesser value and amount reimbursement than the other ones. But that's something I'm kind of interested in hearing from folks, at least in the United States, and I don't know about in other countries how it's handled when you're not working with an anesthesiologist, but I'm kind of seeing what people are doing and how they're handling that.

sedation procedures

institutional privileging

deep sedation documentation

pre-procedure checklist

sedation billing