Do you Struggle with Moderate Conscious Sedation 99144-99145
Moderate Conscious Sedation coding 99144-99145
Moderate conscious sedation (MCS) is a drug given for performing major procedures. The MCS helps in inducing depression of consciousness. MCS includes administration of agents, maintenance of sedation, monitoring of oxygen saturation, heart rate, blood pressure and establishment of IV access. There are few common CPT codes used for coding MCS in Interventional and surgical procedures. Most of the procedures include MCS but few CPT codes do not include these services hence should be coded separately. Let us checkout how to code these CPT codes in medical coding.
CPT codes used for Moderate Conscious Sedation
We have new CPT codes for Moderate Conscious Sedation from 2017. The below CPT code 99143, 99144 and 99145 are deleted from CPT codebook in 2017. There are three CPT codes used frequently which we discuss in the section. The CPT codes 99143, 99144 and 99145 are used very commonly. The first code 99143 is used for minors or babies who are younger than 5 years of age. The second code 99144 is used for patients older than 5 years of age. The last code 99145 is an add-on code and can be used with any of these 99143 and 99144 CPT codes. Below is the detail description of these CPT codes
99143– Moderate Sedation provided by the same physician performing the diagnostic or therapeutic service that the sedation supports for patients younger than 5 years of age for the first 30 minutes of intraservice time.
99144– Moderate Sedation provided by the same physician performing the diagnostic or therapeutic service that the sedation supports, for patients 5 years of age or older for the first 30 minutes of intraservice time.
99145– for each additional 15 minutes of intraservice time.
These codes are already included with cpt codes for central or peripheral venous catheter placement, AV fistula procedure, extremity vascular catheterization codes, stent or angioplasty procedure and few abscess cpt codes. So, do checkout before coding these cpt codes whether they are already a part of procedure or should be coded separately.
Time- Major Factor to decide Moderate Conscious Sedation CPT Code
As we see these CPT codes, time is considered as the deciding factor. The first 30 minutes is coded as primary (99143-99144) code and the additional 15 minutes are coded using the add-on code 99145.So, always check the total time for which MCS is given to assign correct CPT code. The first 30 minutes CPT code can still be coded if the time has passed the halfway i.e. minimum 16 minutes or more. So, even the MCS is given for 16 or more minutes we can go ahead and code 99143 or 99144 depending on the age of the patient. So, never think the time should be exact 30 minutes or more to code these CPT codes. Same thing goes with add-on code 99145, which can be coded even if the time is 8 minutes or more. So, next time check the MCS time properly to calculate and assign correct codes. For example, suppose we have to code 55 minutes for MCS the cpt codes will be 99243 or 99244 primary (first 30 minutes), followed by 99245 (15 minutes from 30 to 45) and again 99145 (next threshold 10 minutes from 45 to 55). So, the add-on code can be used as many times to equal the time.
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