AMA CPT® Assistant - 2009 Issue 11 (November)
Appendix G/Moderate Sedation (November 2009)
November 2009 page 11-end Appendix G: Moderate Sedation, 99143-99145, 99148-99150 (Q&A) Question: How is moderate sedation reported with codes not listed in Appendix G when performed by the same physician in a nonfacility (eg, physician office, freestanding imaging center) setting? Answer: The services listed in Appendix G include moderate sedation as an inherent part of providing the procedure, thus, it is not appropriate for the same physician to report both the procedure and the moderate sedation codes, 99143 - 99145 . The guideline in Appendix G indicates the following, "Since these services include moderate sedation, it is not appropriate...
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Article Overview
This CPT Assistant article reviews a moderate sedation reporting question tied to Appendix G and discusses how the guidance applies in facility and nonfacility settings. It is aimed at coders, billers, and reimbursement staff who need to understand the scope of the Appendix G list, the related CPT sedation code groups, and the note about payer-specific policies.
Why This Topic Matters
Moderate sedation reporting can affect whether separate services are reported together or apart, so understanding the scope of Appendix G helps reduce coding and billing errors. The article also highlights that payer policies may differ, making it useful for anyone responsible for charge capture and claim accuracy.
Article Sections
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November 2009 page 11-end
Introductory publication information and the article’s placement within the CPT Assistant issue.
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Appendix G: Moderate Sedation, 99143-99145, 99148-99150 (Q&A)
A question-and-answer discussion of moderate sedation reporting in connection with Appendix G and non-Appendix G procedures. The section also includes a table summarizing reporting contexts and a brief note about payer-specific guidance.
What You Will Learn
- How the article frames moderate sedation guidance within CPT Appendix G
- What the discussion covers about reporting in facility and nonfacility settings
- Why payer-specific reimbursement policies may need to be checked separately
- How the article distinguishes procedures listed in Appendix G from those that are not
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Compliance staff
- Physician practice managers
Codes Discussed
Code Ranges Discussed
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