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) procedure 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
procedure codes 99155 - 99157, if the site is in a facility setting.