tci ED Coding & Reimbursement Alert - 2016 Issue 12

Reader Question: Check the 2017 Chart for Time Requirements on Additional Units of Moderate Sedation

Question: I read in the November issue that the new moderate sedation codes require a minimum threshold of 10 minutes of intraservice time to report the new codes. Does that same 10 minute threshold apply for the add-on codes if an additional 15 minutes of sedation is required? Texas Subscriber Answer: The time requirement chart following the revised moderate sedation code section in CPT® 2017 shows that although 10 minutes of intraservice time are required for the initial reporting, you need only exceed the midpoint of 15 minutes to qualify for reporting the add-on codes 99153 and 99157. The...

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