Conscious (Moderate) Sedation

January 9th, 2018 - Find-A-Code

Categories: CPT^® Coding Surgical Billing & Coding Anesthesia|Pain Management

Moderate (Conscious) sedation is a drug-induced state of relaxation in which the patient is typically awake and can respond to verbal commands, but might not be able to speak. A combination of medicines is used and often includes a sedative as well as an anesthetic to block pain.

Prior to 2017, many codes were bundled (the professional component of the moderate sedation was included in the procedure.) This change reduces the problem of billing errors when sedation services were provided by a different healthcare provider.

The "Conscious Sedation Coding Table" has two columns for providers. The "Provider who performs procedure" means that the provider performing the procedure is the one that is also performing the conscious sedation. If the sedation is provided by a provider who does NOT perform the procedure, use the "Different Provider" column.

Conscious Sedation Coding Table
Total Sedation Intraservice Time	Provider Who Performs Procedure		Different Provider
	Codes		Codes
	Patient < 5 yrs	Patient > 5 yrs	Patient < 5 yrs	Patient > 5 yrs
10-22 min	99151	99152	99155	99156
23-37 min	99151 + 99153 X 1	99152 + 99153 X 1	99155 + 99157 X 1	99156 + 99157 X 1
38-52 min	99151 + 99153 X 2	99152 + 99153 X 2	99155 + 99157 X 2	99156 + 99157 X 2
53-67 min (53 min to 1 hr 7 min)	99151 + 99153 X 3	99152 + 99153 X 3	99155 + 99157 X 3	99156 + 99157 X 3
68-82 (1 hr 8 min to 1 hr 22 min)	99151 + 99153 X 4	99152 + 99153 X 4	99155 + 99157 X 4	99156 + 99157 X 4
83 min or longer	add 99153	add 99153	add 99157	add 99157

Note: Do not report sedation services of less than 10 minutes.

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