Hello,
Tt’s been almost a year since the implementation of these codes, but I am still unsure of the guidelines. We bill 99152 only (we don’t see kids). We billed 99153 at the beginning but then found out that it’s a PC/TC code. The time is not an issue. What I’m not sure is the pre-service work that’s required. In the book, there are 12 bullet points of pre-service work. Most of the times my doctors have them all in the H&P and Pre-Sedation evaluation. Once in a while they miss the Review of the patient’s previous experiences with sedation complications (bullet #2) and Family hx of sedation complications (bullet #3), when this happens, I don’t bill.
My question: Are they required to have every one of those 12 bullet points reviewed to bill 99152 (and other MCS codes)? Their H&P contains past medical and family histories as well, is this enough or do they have to specifically review bullet #2 and #3 separately. (page 676 on AMA CPT Book 2017)
I have been very strict with them… (for 1/4 RVU!!!), but when I read the internet, I don’t seem to see any explanation. Just want to know what auditors think and how others do at their org.

Thanks a bunch!