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99144 Conscious Sedation

  1. Question 99144 Conscious Sedation
    Medical Coding Books
    Are there any guidelines regarding the time documentation 99144 Conscious Sedation? CPT description states "first 30 minutes", does this mean it must be at least 30 minutes before reporting? Also, what documented times should we be using to calculate the time? I can't seem to find anything in writing regarding these issues. Thanks, any help would be greatly appreciated.

  2. #2
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    Sioux Falls South Dakota
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    Quote Originally Posted by nicoleri View Post
    Are there any guidelines regarding the time documentation 99144 Conscious Sedation? CPT description states "first 30 minutes", does this mean it must be at least 30 minutes before reporting? Also, what documented times should we be using to calculate the time? I can't seem to find anything in writing regarding these issues. Thanks, any help would be greatly appreciated.
    Here are some of the explanatory notes from CPT Assistant, Febr 2006:

    "What Services Are Included in Moderate (Conscious) Sedation?

    When providing moderate sedation, the following services are included and are not reported separately:

    • Assessment of the patient (not included in intraservice time)

    • Establishment of IV access and fluids to maintain patency, when performed

    • Administration of agent(s)

    • Maintenance of sedation

    • Monitoring of oxygen saturation, heart rate, and blood pressure

    • Recovery (not included in intraservice time)

    Intraservice Time

    Intraservice time starts with the administration of the sedation agent(s). It requires continuous face-to-face attendance and ends at the conclusion of personal contact by the physician providing the sedation. Additionally, the service time is included in each of the code descriptors and is also defined in the guidelines"

    Also in this article, there are clinical examples.

    Hope this helps! Be sure to check Appendix G for services that include the sedation.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  3. #3
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    I am also coming across this problem w/ code 99144- Dr. performs bone marrow biopsy w/ consious sedation...Sedation record shows IV of sedative was only 20 minutes long... Am I still able to bill 99144 since the code states the first 30 minutes or does this have to be exactly 30 mins? Is there documentation anywhere stating that something else should be billed for administration or can you not even bill for it??? they are billing out for the drug code J2205 x 7 for the sedative...

  4. Default 99144 conscious sedation
    Good morning,
    Can we code 99144 when we give the patient oral valium before a procedure such as ESI? We do monitor the patient's heart rate and blood pressure prior, during and after the procedure. Thanks. Lynn

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