Anesthesia Coding Alert

Watch the time and who administers the sedation.

CPT^® 2016 includes six codes for moderate sedation; they are divided into two code families based on time and who provides the sedation in relation to who performs the service. Your options are:

• 99143 – Moderate sedation services (other than those services described by codes 00100-01999) 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; younger than 5 years of age, first 30 minutes intra-service time
• 99144 – … age 5 years or older, first 30 minutes intra-service time
• +99145 – … each additional 15 minutes intra-service time (List separately in addition to code for primary service)
• 99148 – Moderate sedation services (other than those services described by codes 00100-01999), provided by a physician or other qualified health care professional other than the health care professional performing the diagnostic or therapeutic service that the sedation supports; younger than 5 years of age, first 30 minutes intra-service time
• 99149 – … age 5 years or older, first 30 minutes intra-service time
• +99150 – … each additional 15 minutes intra-service time (List separately in addition to code for primary service).

Report add-on code +99145 in conjunction with 99143 and 99144, and +99150 with codes 99148 and 99149.

Take note: The October 2011 CPT^® Assistant indicated that the CPT^® standard for time measure does apply to the moderate (conscious) sedation codes 99143-99145 and 99148-99150.

“Per CPT^®, a unit of time is attained when the midpoint has been passed,” says Kelly D. Dennis, MBA, ACS-AN, CANPC, CHCA, CPC, CPC-I, owner of Perfect Office Solutions in Leesburg, Fla. “For example, an hour is attained when 31 minutes have elapsed (more than midway between zero and sixty minutes).”

“Moderate sedation is a time-based code,” Dennis adds. “Because the moderate sedation codes indicate a unit of time of 30 minutes, the chart must indicate 16 minutes or more of intraservice time to report moderate sedation. If the time threshold has not been met, then the code is not reportable.”