ED Coding and Reimbursement Alert

Question: The ED physician responds to a call to see a hospital inpatient suffering from pulmolithiasis. The notes indicate that the physician instituted -BiPAP- to assist the patient's breathing. Should I report this ventilation service with 94002? Minnesota Subscriber Answer: If the physician performs BiPAP or continuous positive airway pressure (CPAP) ventilation, report the service with 94660 (Continuous positive airway pressure ventilation [CPAP], initiation and management). The 94002 (Ventilation assist and management,initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day) code does not accurately describe the service your physician provided. On the claim, report 94660 for the BiPAP (also known as bilevel positive airway pressure) with 518.89 (Other diseases of lung, not elsewhere classified) appended to 94660 to represent the patient's condition.