tci ED Coding & Reimbursement Alert - 2011 Issue 12

Reader Question: Use Correct Time Threshold For Moderate Sedation

Question: In our ED group, our moderate sedations are usually less than 16 minutes. The CPT Assistant® Oct 2011 issue states that if the moderate sedation is less than 16 minutes, it is not separately billable. Is that correct?Wisconsin SubscriberAnswer: The October 2011 CPT Assistant® reference comes from a Commonly Asked Questions Section asking if it is appropriate to report the moderate sedation codes for the first 30 minutes of Intraservice time if only 10 minutes of moderate sedation are provided. The answer given was no.The rationale offered was that moderate sedation codes are time based and...

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