Pulmonology Coding Alert

Quick Tips for Coding Respiratory Treatments

Your code depends on where the physician places the mask

1. Use these ICD-9 codes for respiratory failure:

  •  518.81 -- Acute respiratory failure
  •  518.83 -- Chronic respiratory failure
  •  518.84 -- Acute on chronic respiratory failure

    2. You should know the physician's method for administering ventilation management to pick the right procedure code, coding experts say. For instance, use 94656 (Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; first day) for the first day that the pulmonologist initiates a noninvasive method of ventilator management.

    3. If the pulmonologist applies a mask to a continuous positive airway pressure ventilation machine to check for positive airway pressure, you should select 94660 (Continuous positive airway pressure [CPAP] ventilation, initiation and management).

    4. Never bill ventilator management codes (94656-94662) in addition to E/M codes (for example, established patient codes 99211-99215). Medicare considers ventilator management inclusive with a physician's evaluation services.

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