Learn 7 Must-Know Principles of Moderate Sedation Coding
Published on Wed Nov 16, 2005
CPT 2006 replaces 99141-99142 with provider, age and time-specific codes This winter you should stop looking at the administration route to select the correct sedation code and instead focus on three details: the number of non-anesthesiologist providers, the patient's age and the moderate sedation time.
CPT 2006 deletes conscious sedation codes 99141 (Sedation with or without analgesia [conscious sedation]; intravenous, intramuscular or inhalation) and 99142 (...oral, rectal and/or intranasal) and replaces them with six new codes, ranging from 99143-99150. "The new system allows the coder to represent the service more accurately using provider, age and time divisions," comments Jack Percelay, MD, MPH, FAAP, immediate past-chairperson of the American Academy of Pediatrics (AAP) Section on Hospital Medicine and pediatric representative to the Board of Society of Hospital Medicine.
These fundamentals will prepare you to use the new codes, effective Jan. 1, which include the following:
• CPT 99143 --Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician 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; under 5 years of age, first 30 minutes intraservice time
• 99144--... age 5 years or older, first 30 minutes intraservice time
• +99145--... each additional 15 minutes intraservice time (list separately in addition to code for primary procedure)
• 99148--Moderate sedation services (other than those services described by codes 00100-01999), provided by a physician other than the health care professional performing the diagnostic or therapeutic service that the sedation supports; under 5 years of age, first 30 minutes intraservice time
• 99149--... age 5 years or older, first 30 minutes intraservice time
• +99150--... each additional 15 minutes intraservice time (list separately in addition to code for primary procedure). 1. Think of Conscious Sedation as Moderate Sedation You can forget the term conscious sedation and start referring to this service as moderate sedation. "Moderate sedation is the most clinically relevant term used to describe the services provided," explains David Jaimovich, MD, section chief of the division of pediatric critical care for Hope Children's Hospital in Oak Lawn, Ill. Therefore, CPT 2006 revises the code family's subhead and guidelines "to reference conscious sedation as the secondary, less preferred term to describe moderate sedation services," wrote Jaimovich in the September 2005 AAP Section on Critical Care Medicine.
The guidelines will define the upper and lower levels of moderate sedation. "Moderate sedation does not include minimal sedation (anxiolysis), deep sedation or monitored anesthesia care (00100-01999)," states CPT's "Moderate (Conscious) Sedation" introductory notes. 2. Answer '1 MD or 2?' to Choose Code Family Unlike the conscious sedation codes that you assigned by administration route, CPT breaks the [...]
