Cardiology Question for the Week of February 6, 2017

Cardiology Compliance Question of the Week

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.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.