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Moderate Conscious Sedation removed from CPT codes in 2017: Must Read

Moderate conscious sedation is a drug-induced depression of consciousness which is used for performing surgeries. With moderate conscious sedation the patient responds purposefully to verbal commands. Interventional radiology and open surgery procedures requires moderate conscious sedation. But, from 2017 new cpt codes have been added for moderate conscious sedation. The old CPT codes for conscious sedation 99143, 99144, 99145 have been deleted. We have new CPT code 99151, 99152, 99153, 99155, 99156 and 99157 for coding moderate conscious sedation from 2017. Be careful now, while using these CPT codes in 2017, since many of the CPT codes have been revised which will require to code sedation codes separately.

Moderate Conscious Sedation removed from CPT codes in 2017: Must Read

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Description of CPT code 99151, 99152, 99153, 99155, 99156 and 99157

The detail code description of CPT codes for moderate conscious sedation will help you to understand more about these procedure codes. Earlier we had only three CPT codes 99143, 99144, 99145 (deleted in 2017) which are used for coding sedation. But, now we will be having six CPT codes for coding moderate conscious sedation procedures. Below is the details description of these CPT codes.

99151 Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient younger than 5 years of age

99152    initial 15 minutes of intraservice time, patient age 5 years or older

+ 99153 each additional 15 minutes intraservice time (List separately in addition to code for primary service)

99155  Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger than 5 years of age

99156  initial 15 minutes of intraservice time, patient age 5 years or older

+ 99157 each additional 15 minutes intraservice time (List separately in addition to code for primary service)

Moderate sedation codes 99151, 99152, 99153, 99155, 99156, 99157 are not used to report administration of medications for pain control, minimal sedation , deep sedation, or monitored anesthesia care (0010001999). For coding correct procedure code, intraservice time of moderate sedation is used. For coding these codes, an independent trained observer who is qualified to monitor the patient during the procedure, should be present to monitor the level of consciousness.

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Read also: New CPT codes changes for Angioplasty and Stent Procedures in 2017

Changes with CPT code 99151, 99152, 99153, 99155, 99156 and 99157

Till 2016, most of the percutaneous or interventional radiology procedures include the moderate conscious sedation. For example, the Central venous catheter placement (36558-36571), chest tube placement (32551), stent and angioplasty procedure (37220-37231) etc. which used to include moderate conscious sedation till 2016. But, from 2017 these all codes have been revised, which means the moderate conscious sedation has been excluded from these procedures. From 2017, if you are using these codes you have to use CPT code 99151, 99152, 99153, 99155, 99156 and 99157 along with these procedure codes. Let us take an example for tunneled Central venous catheter placement without port and pump under fluoroscopic and ultrasound guidance with moderate conscious sedation by same physician of 45 minutes of a 50-year-old man, the CPT codes for this exam will be.

In 2017                                                     In 2016

Δ36558                                                      ☉ 36561

77001                                                       77001

76937                                                       76937

99152

99153×2

Read also: Amazing Coding tips for Coding Angiogram in Surgery

How to find out new and revised CPT codes

The new codes will have dark circle (⚫) in front of the CPT code which tells that it is a new CPT code for 2017. You can see this circle in front of the CPT code 99151, 99152, 99153, 99155, 99156 and 99157. The revised codes will have a triangle Δ  which will denote that the CPT codes is a revised code and the definition or description has been changed. So, be careful whenever you are using moderate conscious sedation because from 2017, you have to use these CPT codes frequently as they are no more a part of many procedure codes.

References:

http://www.acc.org/latest-in-cardiology/articles/2016/12/07/08/40/cpt-coding-changes-for-moderate-sedation-in-2017

http://www.physicianspractice.com/coding/coding-moderate-sedation-different-2017

https://www.aapc.com/blog/36784-moderate-sedation-bundles-no-more/

https://www.acep.org/Physician-Resources/Practice-Resources/Administration/Financial-Issues-/-Reimbursement/Moderate-(Conscious)-Sedation-FAQ/

http://blog.supercoder.com/coding-updates/rule-change-if-youve-never-reported-moderate-sedation-before-read-this/

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