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Moderate sedation services, as defined by CPT® Code 99143, involve the administration of sedative agents to a patient who is undergoing a diagnostic or therapeutic procedure. This service is specifically provided by the same physician or qualified healthcare professional who is performing the procedure that necessitates sedation. An essential component of this service is the presence of an independent trained observer, whose role is to assist in monitoring the patient's level of consciousness and physiological status throughout the sedation process. This code applies to patients who are younger than five years of age and covers the first 30 minutes of intra-service time. During the procedure, a thorough patient assessment is conducted, which includes the insertion of an intravenous line for the administration of fluids as needed. The sedative agent is then administered, and the patient is maintained under moderate sedation, with continuous monitoring of vital signs such as oxygen saturation, heart rate, and blood pressure. After the procedure is completed, the physician or qualified healthcare professional remains responsible for monitoring the patient until they have sufficiently recovered from the effects of sedation and can be safely handed over to nursing staff for ongoing care. It is important to note that different codes are used for patients of varying ages and for additional time spent in sedation, with 99144 designated for patients aged five years or older and 99145 for each additional 15 minutes of intra-service time for any age group.
© Copyright 2025 Coding Ahead. All rights reserved.
The indications for the use of CPT® Code 99143 include the need for moderate sedation in patients younger than five years of age who are undergoing diagnostic or therapeutic procedures. This sedation is necessary to ensure that the patient remains calm and comfortable during the procedure, allowing for optimal conditions for the healthcare professional to perform the required service. The presence of an independent trained observer is mandated to monitor the patient's level of consciousness and physiological status, ensuring safety throughout the sedation process.
The procedure for administering moderate sedation under CPT® Code 99143 involves several critical steps to ensure patient safety and comfort. First, a comprehensive patient assessment is performed to evaluate the patient's medical history and current health status, which is essential for determining the appropriate sedation plan. Following the assessment, an intravenous line is inserted to facilitate the administration of fluids and sedative agents. This step is crucial as it allows for quick access to the patient's circulatory system, ensuring that the sedative can be delivered effectively. Once the intravenous line is established, the healthcare professional administers the sedative agent, carefully monitoring the patient's response to the medication. The patient is then maintained under moderate sedation, which requires continuous observation of vital signs, including oxygen saturation, heart rate, and blood pressure, to ensure that the patient remains stable throughout the procedure. After the procedure is completed, the physician or qualified healthcare professional continues to monitor the patient until they have adequately recovered from the sedation effects. This monitoring is vital to ensure the patient's safety before transferring them to nursing staff for further care.
Post-procedure care following the administration of moderate sedation under CPT® Code 99143 involves continued monitoring of the patient until they have fully recovered from the effects of sedation. This includes observing the patient's vital signs and level of consciousness to ensure they are stable and responsive. Once the patient demonstrates adequate recovery, they can be safely handed over to nursing staff for ongoing care. It is essential that the healthcare professional remains vigilant during this recovery phase to address any potential complications that may arise from the sedation. The overall goal is to ensure the patient's safety and comfort throughout the entire process, from sedation to recovery.
| Short Descr | MOD SEDAT PHYS/QHP <5 YRS | Medium Descr | MODERATE SEDATJ SAME PHYS/QHP <5 YRS INIT 30 MIN | Long Descr | Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician or other qualified health care professional performing the diagnostic or therapeuti | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 9 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Type of Service (TOS) | 7 - Anesthesia | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | Not applicable/unspecified. | CCS Clinical Classification | 232 - Anesthesia |
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| 2016-12-31 | Deleted | Code deleted. Use 99151, 99152, or 99153. See Guidelines below for more information. |
| 2013-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Changed | Code description changed. |
| 2006-01-01 | Added | First appearance in code book in 2006. |