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Pulmonology Coding Alert

You Be the Coder:

Manage Your 94660 Coding Carefully

Published on Sun Aug 22, 2010

Question: We are billing a recurring office visit code (99211"99215) with 94660 on the same day, but we are getting denied. On the other hand, when we bill 94660 independently, we get our reimbursement without any hassle. What are we doing wrong? Colorado Subscriber Answer: To bill for 94660 (Continuous positive airway pressure ventilation [CPAP], initiation and management), the physician must provide a face-to-face encounter with the patient. Since this is not a time-based service, it doesn't require physician presence in the room throughout the entire time the patient is in the office. However, it is not an "incident-to" service, which means you cannot report it when another health care provider performs it. Important: You should use 94660 for the initiation and management of CPAP therapy. You bill this code when the treatment is initiated with the patient, in order to describe the initiation and instruction of the patient. If [...]
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