You Be the Coder: Consult Coding
Question: We have a patient who has been diagnosed with both pneumonia and Lou Gehrigs disease. Recently, the patient was admitted to the intensive care unit (ICU) with difficulty breathing, and she currently is using a home vent to assist with respiration. The hospital respiratory therapist did a consult and will be performing updrafts, suctioning, etc. How should we code this? Arterial blood gases have not been ordered, therefore the respiratory therapist has not had to adjust the vent settings.
Arizona Subscriber
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.Answer: You cannot bill separately for ventilation management performed on the same day as an evaluation and management (E/M) service, such as a subsequent hospital day. If you bill both an E/M code and a ventilator management code on the same day, only the E/M code will be paid. When both services occur on the same date, choose one or the otherbased upon the available documentationand bill only that one.
Your decision regarding which service to bill also should be based upon the level of E/M service performed. If ventilator management were performed on the same date as a 99231 (subsequent hospital care, per day, for the evaluation and management of a patient), it would be better to bill for the ventilator management, as it has a higher relative value unit (RVU). But for higher-level E/M codes, such as 99232 or 99233, you will gain greater reimbursement than for the subsequent day for ventilator management (this assumes that the patient is still in ICU when these services are occurring).
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- Published on 2000-08-01
