General Surgery Coding Alert

Question: I’m confused about the moderate sedation changes. My CPT^® 2017 Appendix B, “Summary of Additions, Deletions, and Revisions,” says that you should not report moderate sedation separately when a provider performs both the sedation and a procedure marked with a symbol. The symbol it shows is an image of the bullseye symbol with a line through it. Does that mean all the codes marked with that symbol in the Appendix include moderate sedation?

Codify Subscriber

Answer: The AMA, which manages the CPT^® codes, has published an errata document that addresses the concern that you’ve outlined.

The confusing wording is a publishing error. The AMA’s Errata and Technical Corrections document changes the wording to clarify that CPT^® 2017 deletes the moderate sedation symbol, and that the presence of the bullseye symbol with a line through it in Appendix B means the symbol has been deleted.

Context: CPT^® 2017 eliminates the moderate sedation symbol. One result of the change is that you must report moderate sedation codes to receive reimbursement for that service. This change affects many general surgery services that included moderate sedation as inherent to the procedure in previous years (meaning the procedure included reimbursement for moderate sedation so you could not report the sedation separately). In 2017, you must report a code for moderate sedation to receive payment for that service. The surgical procedures will no longer factor in reimbursement for the sedation.

Resource: You can view the errata document at www.ama-assn.org/practice-management/errata-technical-corrections.