decisionhealth Newsletters, Coder Pink Sheets - 2016 Issue 8 (August)
New coding guidance: 7 new moderate sedation services will have active status, time difference
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Article Overview
This article explains proposed CMS changes for moderate sedation services in the 2017 Medicare physician fee schedule. It is relevant to coders, billers, compliance staff, and providers who report moderate sedation, especially in relation to CPT and HCPCS Level II code updates, status changes, and the shift in service timing structure. The article also summarizes the proposed service categories and the associated fee schedule context.
Why This Topic Matters
The topic matters because CMS proposed changes could affect how moderate sedation services are reported and priced under Medicare. Readers who work with anesthesia-adjacent or procedural coding will want to understand the scope of the upcoming update and how the new code structure is being organized.
Article Sections
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Overview of proposed CMS changes
Introduces the planned Medicare physician fee schedule changes for moderate sedation services and the broader shift in payment status.
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Current and proposed code structure
Summarizes the transition from the existing moderate sedation code set to a new group of proposed codes and outlines the general structure of the update.
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Time-based reporting changes
Describes the change in service timing structure for reporting moderate sedation and the related proposed time framework.
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Proposed moderate sedation services and fees — 2017
Presents the proposed 2017 fee schedule status and payment context for the moderate sedation service categories discussed in the article.
What You Will Learn
- How CMS is proposing to revise moderate sedation reporting for Medicare
- Which code families are being updated in the proposed fee schedule
- How the service timing structure is changing in the proposed policy
- What general fee schedule information is included for the proposed services
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physicians and other qualified health care professionals
- Revenue cycle teams
Codes Discussed
Code Ranges Discussed
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