tci ED Coding & Reimbursement Alert - 2008 Issue 3

Reader Questions: Payers Consider Plug Removal Part of Intubation

Question: The ED physician is trying to intubate a patient but fails due to a mucous plug interfering with the endotracheal tube. The physician removes the plug with forceps. Can I report the plug removal separately? Illinois Subscriber Answer: You should not report the plug removal separately. Report 31500 (Intubation, endotracheal, emergency procedure) for the service.Exception: If the mucous plug removal greatly extended the encounter time and the amount of physician work, you may be able to attach modifier 22 (Unusual procedural services) to 31500. However, be sure you know your insurer's coding rules before you report modifier...

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