4.0 POLICY
4.1 Conscious sedation is bundled
into many procedures. Conscious sedation is not covered separately
when provided by the same physician as it is considered an integral
part of the primary procedure.
4.2 If a physician performs a procedure
that does not bundle conscious sedation and the same physician also performs
moderate sedation, it is appropriate to separately bill Current
Procedural Terminology (CPT) codes 99151 - 99153.
4.3 If a second physician performs
conscious sedation (other than the professional performing the diagnostic or
therapeutic service) it is appropriate to separately bill CPT codes
99155 - 99157, if the site is in a facility setting.