Part B Insider (Multispecialty) Coding Alert

Published on Wed Jun 20, 2007 PDF

Watch out: You can't bill moderate sedation codes 99143-99145 and 99148-99150 in the same session with any code that has a -target- symbol next to it, says Michael Granovsky, president of MRSI in Woburn, MA. These -targeted- codes, which are listed in Appendix G of your CPT book, already include moderate sedation.

CPT puts the -target- on these codes for a specific reason, says Barbara Johnson, owner of Real Code in Moreno Valley, CA. -They don't feel that it's something should be done without some kind of moderate sedation and so it's going to be going to be built into the work RVUs.-

You can only bill moderate sedation if a different physician performs the procedure than the one sedating the patient, and the physicians are in a facility. So if a trauma physician is operating on a patient in the Emergency Department and asks an ED physician to give the patient moderate sedation, then you might be able to bill for the sedation separately.

But coding experts say it's uncommon for the -targeted- procedures to need a separate sedation physician.