Theresa,
This is very confusing, there are two types of moderate (conscious) sedation codes, physician directing the sedation AND who is performing the procedure at the same time. The other is provider providing the sedation is NOT performing the procedure. I take the 2nd kind as CRNA directed sedation.
First type:
99151 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 younger than 5 years of age
99152 initial 15 minutes of intraservice , patient age 5 years or older
Sedation must at least 10 minutes of sedation to bill this code
Sedation less than 10 minutes is not billed.
+99153 Each additional 15 minutes of intraservice time
Each additional must have additional 8 minutes to bill this code
(Use 99153 in conjunction with 99151, 99152)
(Do not report 99153 in conjunction with 99155, 99156)
second type:
99155 Moderate sedation services provided by a physician or other qualified health care professional performing the diagnostic or therapeutic service other than the physician or other qualified health care professional 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 younger than 5 years of age
99156 initial 15 minutes of intraservice , patient age 5 years or older
Sedation must at least 10 minutes of sedation to bill this code
Sedation less than 10 minutes is not billed.
+99157 Each additional 15 minutes of intraservice time
Each additional must have additional 8 minutes to bill this code
(Use 99157 in conjunction with 99155, 99156)
(Do not report 99157 in conjunction with 99151, 99152)
For codes 99151, 99152, 99153 when MD /QHCP performs the procedure and provides the sedation services, they will supervise and direct an independent trained observer who will assist in monitoring the patient’s level of consciousness and physiological status throughout the procedure
An independent trained observer is an individual who is qualified to monitor the patient during the procedure, who has no other duties (e.g., assisting at surgery) during the procedure
the chart In the CPT book helps understand the time requirements.
I hope this helps,
Margaret Morgan, CPC, CIRCC