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ED E/M-25, CPR?

Taylor Posted Fri 22nd of November, 2019 12:46:17 PM
For ED MD only, could you please explain when it is appropriate to assign an E/M-25, along with 92950? Questioning when pt arrives coding via ambulance and we continue CPR and pt expires in ED. Thanks.
SuperCoder Answered Mon 25th of November, 2019 13:03:01 PM

Our team is working on this query, will get back to you soon.

SuperCoder Answered Mon 25th of November, 2019 13:06:36 PM

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Hi Taylor,

CPR is a non-E/M service encompassing such activities as supervising or performing chest compressions, adequate ventilation of the patient (e.g., bag-valve-mask), etc. CPT does not list a typical time to qualify for providing CPR.

 As a separately reportable service with E/M the modifier is not required. It is just that when the patient encounter does not satisfy Critical Care requirements, the E/M level of service (e.g., 9928X) should be determined by the extent of the History, Physical Exam, and Medical Decision Making performed. It is reasonable that a complete history might not be available to the provider, but attempts should be made to gather history from available sources such as EMS or other family member.

It is just that the E/M level should be proportional to the amount of work performed determining the patient’s history, the extent of the physical exam, and the degree of medical decision making while CPR is being performed. 

Feel free to ask for any further query.

Regards,

Rabia.

SuperCoder Answered Tue 26th of November, 2019 14:15:15 PM

.

Hi Taylor,

CPR is a non-E/M service encompassing such activities as supervising or performing chest compressions, adequate ventilation of the patient (e.g., bag-valve-mask), etc. CPT does not list a typical time to qualify for providing CPR.

 As a separately reportable service with E/M the modifier is not required. It is just that when the patient encounter does not satisfy Critical Care requirements, the E/M level of service (e.g., 9928X) should be determined by the extent of the History, Physical Exam, and Medical Decision Making performed. It is reasonable that a complete history might not be available to the provider, but attempts should be made to gather history from available sources such as EMS or other family member.

It is just that the E/M level should be proportional to the amount of work performed determining the patient’s history, the extent of the physical exam, and the degree of medical decision making while CPR is being performed. 

Feel free to ask for any further query.

Regards,

Rabia.

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