ED Coding and Reimbursement Alert

Question: A critical care patient presented in the emergency department, and the physician defibrillated her with 360 joules and gave her intravenous medication. Can we consider this to be CPR, or should I bill a different service? The doctor spent fewer than 30 minutes with the patient.

Ohio Subscriber Answer: There is no CPT code for defibrillation. This service is considered a bundled part of cardiopulmonary resuscitation (CPR) or of critical care. Don't confused defibrillation with CPT code 92960 (Cardioversion, elective, electrical conversion of arrhythmia; external), as this code does not describe emergency defibrillation.

If the patient required defibrillation, she may likely have also required additional aspects of CPR care, such as bag valve mask support, chest compressions, or advanced cardiac life support drugs. If the chart reflects some of these additional aspects of CPR, you could report code 92950 (Cardiopulmonary resuscitation).

If you are reporting critical care, you will use one of two codes: 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) and +99292 (Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes).