Pulmonology Coding Alert

Question: We frequently use noninvasive ventilation, bi-level positive airway pressure (BiPAP) and continuous positive airway pressure (CPAP), to avoid intubation in patients. This requires a lot of physician time at the bedside. Is there a code to report supervision of BiPAP? Is it reimbursed? Is it bundled into the evaluation and management (E/M) codes?

California Subscriber

Answer: Code 94660 is used to bill for the initiation of CPAP or BiPAP. But if there are any other E/M services on the same day, including critical care, you may bill for the ventilation initiation or the E/M service, not both.

Bill the service that takes precedence during the day. Critical care would take precedence over CPAP or BiPAP. CPAP or BiPAP might or might not take precedence over an E/M service.