Date Issued: 12/14/2016
Effective January 1, 2017, in accordance with AMA CPT coding guidelines, a number of changes have been made to the moderate sedation codes and guidelines. These changes include deletion of the existing moderate sedation codes that identified 15 or 30 minute sedation periods (CPT codes 99143, 99144, 99145, 99148, 99149 and 99150); addition of six new CPT codes to identify 15 minute increments for sedation (CPT codes 99151, 99152, 99153, 99155, 99156 and 99157); revision of the accompanying guidelines and parenthetical notes associated with moderate sedation in the AMA CPT Code book; addition of a table to assist users in identifying the correct codes for reporting moderate sedation services which is also found in the AMA CPT Code book.
In addition, moderate sedation has been removed from the services in which it previously inherently included. The corresponding appendix that listed codes that inherently included moderate sedation, appendix G, has been removed from the 2017 AMA CPT Code book as codes will no longer inherently include moderate sedation.
Medicare Moderate Sedation Coverage:
CMS has also created a new HCPCS code (HCPCS code G0500, which EmblemHealth will allow for Medicare members only) to be reported for moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service.