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Moderate Sedation Codes

N

Nelsen

Contributor
Messages
10
Location
Lakewood, CO
I am in need of help, starting 7/1 we stopped getting paid on 99152, 99153 and sometimes g0500 for our endoscopy procedures. I can not find anywhere where coding guidelines have changed on these codes. Can anyone help me with this please?
Thanks in advance!
 
Moderate Sedation Coding

AAPC did a Webinar on Moderate Sedation coding, very helpful and informative. You may want to check it out. I did learn that 99153 has no RVUs and will not get paid. Our practice still bills it for reporting purposes.
 
The CCI edits changed on these codes on 07/01/17 only allowing payment on the sedation codes when a modifier is applied. As the procedure is considered a component of most services, it should only be appended when appropriate as it now has a "column 2" edit.

Modifiers that may be used under appropriate clinical circumstances to bypass an NCCI edit include: E1-E4, FA, F1-F9, LC, LD, LM, LT, RC, RI, RT, TA, T1-T9, XE, XP, XS, XU, -24, -25, -27, -57, -58, -59, -78, -79, and -91.
 
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