ED Coding and Reimbursement Alert

Question: When more than one physician participates in a CPR service for a patient, which code should I report? In particular, I-d like to know what I should report if the physician leads the service, and what should I report if our physician simply assists in the CPR? Montana Subscriber Answer: CPR (92950, Cardiopulmonary resuscitation [e.g., in cardiac arrest]) is a physician-performed service when the ED physician is present during the mechanical respirations and chest compressions. It consists of these functions only, and cannot be described as "ACLS protocols in progress." ACLS (advanced cardiac life support) protocols might or might not involve actual heart and lung manipulation; often they involve only drug administration and close monitoring. When the physician is present during the CPR event and is chiefly responsible for it, she should bill 92950. Only one physician can be the physician-in-charge, so only one can bill for it. The physician does not have to be doing the mechanical movements during CPR, but must be present while they are being performed. If your ED physician is assisting in the CPR while another doctor performs the main service, then your physician may be able to report an E/M code (99281-99285), depending on whether she performed any E/M services in place of the lead physician. Your physician cannot report the 92950 when she is assisting another physician, however.