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Thread: V46.8 for CPAP for OSA?

  1. #1
    Join Date
    Apr 2007

    Question V46.8 for CPAP for OSA?

    AAPC: Back to School
    If a patient uses a CPAP machine for OSA, can code V46.8 apply?

  2. #2

    Default RE: ICD:Status ventilator( respirator) V46.11

    We do have a specific ICD V46.11.
    A continuous positive airway pressure (CPAP) ventilator, also known as a CPAP machine.

    Status/respirator- V46.11
    Dependence /]ON/ respirator (ventilator)- V46.11

    PDX- OSA
    SDX: V46.11

    Assign primary diagnosis explaining why the physician prescribed a CPAP machine, ie., OSA in this scenario
    Code V46.11 is only used if there are NO complications or malfunctions of the respirator equipment, and is always a secondary code.

    Per ICD-9-CM Official Guidelines For Coding and Reporting
    Categories V42-V46,and subcategories V49.6,V49.7 are for use only if there are NO complications or malfunctions of the organ or tissue replaced,the amputation site or the equipment on which the patient is dependent. These are always secondary codes.


    Last edited by msrd_081002; 12-20-2010 at 02:56 AM.

  3. #3


    Do not use v4611 for osa patients who use a cpap. These patients only use the machines when they are lying down. By coding respirator depency status you are implying that this person must be on the cpap continuously. V4611 has an hcc code/value of 77 and if the patient is on medicare you may be audited by cms costing your company a good deal of money.

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