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Kopp billing Posted Sun 29th of January, 2012 01:13:47 AM

SuperCoder Answered Sun 29th of January, 2012 23:00:42 PM

Daily management of a patient on chronic ventilator therapy does not meet the criteria for critical care unless the critical care is separately identifiable from the chronic long-term management of the ventilator dependence.
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So, if the VAP is severe or causes an acute exacerbation of the underlying illness, then documenting and using one of the critical care codes (99291 [Critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 minutes] and possibly +99292 […each additional 30 minutes]) may be most appropriate.
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In such a situation, we can bill Critical Care to the NPP with modifier 25.
MD can be billed either with 94002-94003 or subsequent hospital care 99231-99233 as appropriate.

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