Anthem Blue Cross and Blue Shield New Hampshire prior authorization 99153

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 99153: Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; each additional 15 minutes intraservice time (List separately in addition to code for primary service)

Code

99153

Description

Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; each additional 15 minutes intraservice time (List separately in addition to code for primary service)

Source

New Hampshire Precertification List, Pg 13 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization