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ED Coding and Reimbursement Alert

You Be the Coder:

CPR Coding

Published on Thu Jun 01, 2000

Question: When billing for CPR, does it matter who is actually performing it? Can we bill it if emergency medical systems (EMS) does it in the presence of the physician?

Pennsylvania Coder

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.





Answer: Certain carriers recognize that CPR in the hospital setting is always performed with a physician present to direct and supervise the procedure. According to Cindy McMahan, CPC, an independent coding consultant based in Albany, Wisc., these carriers will allow physicians to bill code 92950 (cardiopulmonary resuscitation [e.g., in cardiac arrest]) even though they are not actually performing the percussions or respirations.

The physician is always the captain of the ship in this situation and must be totally focused on the management of the patient, which includes the CPR, as well as the defibrillation and administration of medications. In that there is carrier variation, it is necessary to check with your local payers to assess their coverage of this service.
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