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Otolaryngology Coding Alert


CPAP and Hospital Care--1 Code or 2?

Question: An allergist 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, per day, 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 service  rather than simply ventilation management.

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