Wiki Moderate sedation

[DavitaBrannon03]

Hi all! I am having trouble discerning when my provider can charge the new moderate sedation codes. The facility that our scopes are done at uses CRNAs and not anesthesiologists. I know the CRNA does bill and I am working on getting an example from the facility that will show what codes and methods they use to bill. I have tried to get specific information from the CMS website, but I only find the list of the RVU revision for the codes that used to include moderate sedation.

I have two questions:

What would be the qualifying circumstance for 99152 vs 99156? I'm not clear on the wording for 99156.

Can my provider bill either of these two codes if the CRNA is also billing given the appropriate documentation is submitted by my provider?

Any help is really appreciated.

 

[GastroGal]

Bill 99152 if Moderate sedation services provided by the same physician or other qualified health care professional 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; initial 15 minutes of intraservice time, patient age 5 years or older

Bill 99156 if Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient age 5 years or older