What are the coding and billing rules for ventilator use in the Emergency Department, including cases of patient transfer or expiration?
Ventilators used in the Emergency Department (ED) cannot be coded if the patient expires in the ED or is transferred from the ED to another facility. Ventilation management CPT® codes (94002 and 94003 or BiPap/CPAP with 94660) are not separately reportable with evaluation and management (E&M) CPT codes. If an E&M code and a ventilation management code are reported, only the E&M code is payable. The Level of Care code billed by the hospital for the Emergency Department episode of care is an Evaluation and Management CPT which is why the Ventilation Management in the Emergency Department is not separately billable.
This question was answered in our annual Respiratory Therapy Reimbursement & Compliance Update webcast. 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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