Wiki Moderate sedation CPT code 99153 - Medicare denials

[vidraj]

Hello!

Is there any update on Medicare denial - for billing additional Moderate sedation time - CPT code 99153 for Cardiology procedures in a facility setting?

https://www.cgsmedicare.com/partb/pubs/news/2017/03/cope2489.html - is the closest I could find.

Looking for any updates for the year 2022, to share it with the providers.

If you have any, can you please share the link here?

TIA,
Vid.

 

[Denises]

Hello,
Have you looked at the 2022 National Physician Fee Schedule RELATIVE VALUE File on the CMS website? The column J-heading of "Facility NA Indicator" has an NA Indicator for all Facility Settings. Meaning, an “NA” in this field indicates that this procedure is rarely or never performed in the facility setting, hence your denials. Here is the CMS website link: https://www.cms.gov/Medicare/Medica...nt/PhysicianFeeSched/PFS-Relative-Value-Files

Hope this helps!

 

[vidraj]

Thank you for explaining and for the link too.