What are the appropriate codes for ventilation management services provided in a skilled nursing facility, extended care/assisted living facility, and patient home, and how are these services billed?
In the acute care setting, there are two codes that represent services provided in the skilled nursing facility, extended care/assisted living facility, and patient home. Nursing facilities will bill for invasive ventilation management on a per-day basis with CPT® 94004. If providing home ventilation management services, the CPT code 94005 represents physician oversight and revision of the patient’s plan of care based on clinical status, laboratory values, or results of other studies. This CPT is billed once per month and is considered a professional service only.
This question was answered in our Coding Essentials for RT/Pulmonary Function. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.
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