Moderate Conscious Sedation CPT 2017 Updates

           As per 2017 CPT coding Guidelines the CPT no longer to defines Moderate Conscious Sedation as an inherent part of any Procedure. (i.e we need to bill Moderate sedation separately). Moderate sedation codes are time and age based codes. The updated Intra-service time thresholds have dropped from 30 minutes to 15 minutes.

Code Description:

• 99151: Moderate Sedation Services provided by the same physician (OR) other qualified healthcare 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 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 or 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 healthcare professional other than the physician (OR) other qualified healthcare 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)

Additional Coding Tips:

• 99143, 99144, 99145 have been deleted and replaced by new codes 99151, 99152, 99153.
• 99148, 99149, 99150 have been deleted and replaced by new codes 99155, 99156, 99157.
• Codes 99151 – 99157 are not used to report administration of medications for pain control, minimal sedation (Anxiolysis), deep sedation, monitored anesthesia care (00100-01999).
• An Independent trained observer is an individual who is qualified to monitor the patient during the procedure, who has no other duties (Ex: assisting surgery) during the procedure.
• Codes 99151 – 99157 includes pre, intra and post service workup associated with Moderate Sedation Service.

Time	Age	CPT Codes
		Same Provider	Another Provider
< 10 minutes	Any age	No CPT Code	No CPT Code
10 to 22 minutes	Younger than 5 years	99151	99155
10 to 22 minutes	5 years or older	99152	99156
23 to 37 minutes	Younger than 5 years	99151, 99153	99155, 99157
23 to 37 minutes	5 years or older	99152, 99153	99156, 99157
38 to 52 minutes	Younger than 5 years	99151, 99153*2	99155, 99157*2
38 to 52 minutes	5 years or older	99152, 99153*2	99156, 99157*2
53 to 67 minutes	Younger than 5 years	99151, 99153*3	99155, 99157*3
53 to 67 minutes	5 years or older	99152, 99153*3	99156, 99157*3
68 to 82 minutes	Younger than 5 years	99151, 99153*4	99155, 99157*4
68 to 82 minutes	5 years or older	99152, 99153*4	99156, 99157*4