Pulmonology Coding Alert

Question: A pulmonologist performed CPAP (94660) in addition to 99233. Should I separately bill the service and the procedure?


Florida Subscriber


Answer: Because of National Correct Coding Initiative edits, you can never bill ventilator management (94660, Continuous positive airway pressure ventilation [CPAP], initiation and management) with an E/M code, such as 99233 (Subsequent hospital care, for the evaluation and management of a patient ...).

You should choose either the E/M or the ventilation management depending on the physician's documentation. Usually, the physician's documented level of assessment and decision-making will justify billing an E/M code rather than simply ventilation management.