Question:

I have another question about moderate sedation code assignments. The descriptions of codes 99151–99153 indicate 15 minutes of service time. What if there is less than 15 minutes? Can this be billed?

Answer:

At least 10 minutes of moderate sedation time must occur before the initial code (99151 or 99152) may be reported. If less than 10 minutes is performed, it is not separately billed. Before the additional 15 minutes code (99153) is reported, more than one-half of the additional 15 minutes must pass.

For instance, to bill 99152 and 99153, the physician should provide the full initial 15 minutes plus at least eight additional minutes of sedation. The CPT book has a time chart to help determine codes billed for longer terms of moderate sedation.

Facebook
Twitter
LinkedIn

CPT® copyright 2023 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.

Unlock 50% off all 2024 edition books when you order by July 5! Use the coupon code CO5024 at checkout to claim this offer!

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24