Wiki 35 minutes only 99144 CPT Assitant July

dwaldman

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Question

Using the new CPT “Time” guidelines for reporting time-based codes, how would moderate sedation performed by an independent observer on an adult that lasts 35 minutes be reported?

Answer

Based on the CPT guidelines' instruction on “Time,” code 99144, Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician 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; age 5 years or older, first 30 minutes intra-service time, should be reported once. The rationale for reporting is that the “35 minutes” is closer to the stated time in code 99144 as opposed to the 15-minute time increment stated in code 99145. The CPT “Time” guidelines state: “When codes are ranked in sequential typical times and the actual time is between two typical times, the code with the typical time closer to the actual time is used.”
 
I meant for the spelling to be "assistant" in the heading

The reason I posted this is awhile go I tried to respond to a post using CPT Assistant reference from 2006 they stated this could be as 99144 99145 for 35 minutes and return post from the forum member who poised the question was that they had read the "time guidelines" in the CPT manual and felt that for 99144 it would represent 16-37 minutes and 99145 can be billed after 38 minutes up to 52 minutes. When I saw their post and read those guidelines I felt their interpretation sounded right and it was interestign to point out that they have suggested that the time guidelines that they placed in the CPT manul supercedes their 2006 statement.
 
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