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Anesthesia Coding Alert

Reader Question:

Units for Ventilation Assist

Published on Tue Oct 01, 2002

Question: Our anesthesiologists are concerned that billing eight units for 94656 (Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; first day) is overbilling since they only spend 20 to 30 minutes with the patient. Is this the only code to use? Can you suggest ways to make our physicians more comfortable with billing this service? New Jersey Subscriber Answer: Most carriers will not allow E/M codes or subsequent hospital visits to be charged for ventilator management, so the initial eight units for code 94656 help make up the difference. You might want to run a report for your group's ventilation procedures to track reimbursement. Once the physicians see how the higher-unit code is balanced by follow-up care they may not be able to bill for, they may feel more comfortable with the eight units.    
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