Moderate sedation can be reported separately. Appendix G which listed bundled moderate sedation services and the bullseye have been removed from the CPT book.
The existing six codes, 99143-99145 and 99148-99150, were deleted and replaced with the following:
- 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 intra-service time, patient younger than 5 years of age
- 99152 – initial 15 minutes of intra-service time, patient age 5 years of older
- +99153 – each additional 15 minutes intra-service 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 intra-service time, patient younger than 5 years of age
- 99156 – initial 15 minutes of intra-service time, patient age 5 years or older
- +99157 – each additional 15 minutes intra-service time (List separately in addition to code for primary service)
The 15 minutes is a reduction from the previous 30 minutes in the deleted codes. A time table is located on page 678 of the CPT book. Less than 10 minutes is not reported separately.
Intra-service time begins at administration and ends when the service is complete.
Important: Medicare has a code for GI endoscopic services only. It is G0500. As stated in the description, the add-on for additional time is 99153.
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that 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 intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)
Codes 99155-99157 are not reportable in the non-facility setting.