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Moderate sedation services, as defined by CPT® Code 99150, refer to the administration of sedative agents to patients undergoing diagnostic or therapeutic procedures. These services are specifically provided by a physician or other qualified healthcare professional who is not the individual performing the primary procedure that necessitates sedation. The process begins with a thorough patient assessment to ensure safety and appropriateness for sedation. An intravenous (IV) line is then established, allowing for the administration of fluids and sedative medications as required. Throughout the procedure, the patient's vital signs, including oxygen saturation, heart rate, and blood pressure, are continuously monitored to ensure their safety and comfort. After the procedure is completed, the healthcare professional responsible for sedation continues to observe the patient until they have sufficiently recovered from the effects of the sedative, at which point the patient can be safely handed over to nursing staff for ongoing care. It is important to note that for patients younger than five years old, the initial 30 minutes of moderate sedation is coded using 99148, while for patients aged five years or older, the appropriate code is 99149. CPT® Code 99150 is utilized to bill for each additional 15 minutes of intra-service time for patients of any age, ensuring that the sedation services provided are accurately captured and reimbursed.
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Moderate sedation services are indicated for patients undergoing various diagnostic or therapeutic procedures that may cause discomfort or anxiety. The following conditions or situations may warrant the use of moderate sedation:
The procedure for administering moderate sedation involves several critical steps to ensure patient safety and comfort throughout the process. Each step is outlined as follows:
Following the administration of moderate sedation and the completion of the procedure, the patient is closely monitored for any adverse reactions or complications related to the sedation. The healthcare professional remains vigilant in observing the patient's responsiveness and vital signs until the patient has sufficiently recovered. Once the patient is stable and alert, they can be safely handed over to nursing staff for ongoing care. It is important to provide the patient and their caregivers with post-procedure instructions, including information on potential side effects of the sedation, activity restrictions, and when to seek further medical attention if necessary.
| Short Descr | MOD SED DIFF PHYS/QHP ADD ON | Medium Descr | MODERATE SEDATJ DIFF PHYS/QHP EA ADDL 15 MIN | Long Descr | Moderate sedation services (other than those services described by codes 00100-01999), provided by a physician or other qualified health care professional other than the health care professional perfo | Status Code | Carriers Price the Code | Global Days | ZZZ - Code Related to Another Service | 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) | Y1 - Other - Medicare fee schedule | MUE | Not applicable/unspecified. | CCS Clinical Classification | 232 - Anesthesia |