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99153 billing

Terry Posted Fri 12th of June, 2020 10:35:07 AM
When billing 99153 and the CS extends to 41 minutes, to report the additional time would you simply add in the unit field the number 2 ? Say the base CS code is used for the first 15 min. then it extends into an additional 26 minutes. How would this be reported?
SuperCoder Answered Mon 15th of June, 2020 03:47:23 AM

Hi Terry,

The provider performing a diagnostic or therapeutic procedure administers one or more drugs to reduce the patient’s level of consciousness (awareness of surrounding environment) in the presence of an independent trained observer. He asks the patient to react purposefully to verbal commands. The provider administers further doses of the drugs as required. He monitors the patient until the end of the procedure. He ensures the patient’s condition is stable at that time. CPT 99153 code is an add-on code for each additional 15 minutes of intra-service time beyond the 15 minutes covered by the primary code. So, in your case, 2 additional units can be billed for 41 minutes CS, because third unit is not meeting the required timing; 15+15+11=41 minutes.

Hope this helps!

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