Question:

Is it appropriate to charge 94150 for ventilator weans? If not, what should be charged?

Answer:

Weaning parameters or weaning procedures are inherent in ventilation management. There is not a separately billable CPT® code for weaning the patient. The cost for ventilation management is captured in the daily charge that is represented by the following initial day and subsequent day CPT codes:

In addition to the American Medical Association’s CPT code definitions, a hospital would refer to the American Hospital Association (AHA) guidelines that address the definition of time associated with mechanical ventilation, which state the following:

94002 Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day
94003 each subsequent day

“Mechanical ventilation start time, duration, and end time is specifically defined in the official coding guidelines. Mechanical ventilation duration includes the time the patient is on the ventilator and the weaning period. Review the guidelines for various examples of when mechanical ventilation start time occurs. Stop time occurs when the mechanical ventilation is turned off and the weaning period is complete.” (AHA Coding Clinic on ICD-9-CM, Fourth Quarter 1992, pages 16–21, Third Quarter 2010, pages 3 and 4)

CPT® is a registered trademark of the American Medical Association.

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CPT® copyright 2021 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.