• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Moderate sedation CPT code 99153 - Medicare denials

Create Wiki
V

vidraj

Guru
Messages
142
Location
Buffalo Grove, IL
Best answers
0
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.
 
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!
 
You must log in or register to reply here.
Top