tci Part B Insider - 2013 Issue 26

Reader Question: Avoid Billing CPAP With E/M

Question: Our pulmonologist recently provided E/M services and also performed ventilation using CPAP. Can we bill the E/M services with the CPAP therapy? We tried doing this but we got denied. What codes should we report when our pulmonologist provides these services together? Answer: You should use 94660 (Continuous positive airway pressure ventilation [CPAP], initiation and management) for the initiation and management of CPAP therapy. You bill this code when the treatment is initiated, in order to describe the initiation and instruction to the patient. If the patient returns and requires additional instruction on use or other issues related...

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